9^th International Conference on Endocrinology and Diabetes Summit September 13-14, 2017 Singapore

Biography:

Li Li is an Assistant Professor at the University of Alabama, School of Medicine in the USA. Her research focuses on insulin resistance, pre-diabetes and obesity in individuals with major depressive disorder and child abuse and more generally, individuals with comorbid mental illness and metabolic syndrome. She currently holds a K23 career development award from the National Institute Health to support her research. Her other ongoing projects include investigating the relationship between inflammation and child abuse in individuals with depression and using exercise as an interventional approach to manage depression and metabolic syndrome. In addition to her practice and research, she also directs the evidence-based medicine and mechanisms in psychiatry curriculum and administers the research programs for residents.

Abstract:

Aims: Childhood maltreatment (CM) is shown to be associated with obesity and depression. However, the relationship of CM to type-2 diabetes mellitus is much less studied. We tested the hypothesis that CM increases the risk for type-2 diabetes mellitus due to glucose intolerance, reduced insulin sensitivity and beta cell function.

Methods: Oral glucose tolerance test (OGTT)-derived metabolic parameters of glucose tolerance, insulin sensitivity and beta cell function were evaluated in 121 participants aged 19-60 years. CM exposure was measured using the Childhood Trauma Questionnaire. Blood samples were collected to measure the inflammatory factors.

Results: After controlling for age, race, gender, education and depression, about 15% higher glucose area under the OGTT curve was observed in the CM group. CM individuals also exhibited impaired insulin sensitivity manifested by the Matsuda index and homeostasis model assessment of insulin resistance, which were correlated with CM severity after adjusting for depression. CM group showed approximately 50% lower disposition index. C-reactive protein and tumor necrosis factor-α levels were greater in the CM group vs. the non-CM group and both were correlated with CM severity (r=0.21, 0.23, respectively, both p<0.05). Multiple regression analyses revealed that CM contributed to reduced insulin sensitivity and lower disposition index independent of depression and obesity.

Conclusions: These data suggest an important relationship between CM and increased risk for type-2 diabetes mellitus due to glucose intolerance, impaired insulin sensitivity and beta cell function. Our findings indicate that CM appears to be an independent risk factor for developing type-2 diabetes mellitus. 

Biography:

Emmanuel Mukwevho is a Professor of Biochemistry at the School of Chemical and Physical Sciences at the NWU, South Africa. He has completed his PhD from University of Cape Town, South Africa. He has also obtained certificates in Project Management and in Financial Management from UCT. Presently, he has registered for MBA with NWU Graduate Business School.

Abstract:

AMPK is known to control glucose and lipid metabolism, two main candidates critical in the development of type-2 diabetes (T2D). Studies have shown that AMPK can be activated by adiponectin. Patients suffering from T2D are known to have low adiponectin concentration in their blood plasma. In this study we have assessed one anti-diabetic compounds; Oleanolic Acid (OA), if it could produce desirable effect in up-regulating adiponectin concentration and the subsequent regulation of AMPK. Sprague Dawley rats were fed with high fructose diet (HFD) to induce T2D and the rats that developed insulin resistance were considered as diseased, they were then treated with OA. Analysis of adiponectin concentration in blood plasma was done, AMPK gene expression and subsequent genes that play vital role in glucose and lipid metabolism (GLUT-4 and CPT-1) in skeletal muscle tissue was also performed. The results showed 1.19 folds increase in blood plasma adiponectin concentration after OA administration. Furthermore AMPK gene expression showed 3.98 folds increase and GLUT-4 gene expression was increased with 1.5 fold whereas CTP-1 gene expression was increased with 1.59 folds. These results clearly indicate that OA produced good effects in ameliorating insulin resistance since it was able to up-regulate all the genes and adiponectin concentration which are well known to be abnormally suppressed in a situation of T2D. In conclusion, this study further confirms that OA can be used as an effective therapeutic agent to ameliorate T2D and this study also suggest that OA’s mechanism of action could be through AMPK pathway.

Biography:

Christoph Sperker has specialized in Laproscopic Surgery and Bariatric Surgery. He is a Visiting Professor to the Medical University of Vienna and is passionate in teaching and passing on his skills. His main focus in the field of bariatric surgery is nutrition and deficiencies after bariatric surgery depending on PPI medication.

Abstract:

Introduction: Malabsorption and micronutrient deficiencies are known problems after bariatric surgery. Therefore, supplementation and regular controls are inevitable. Calcium (Ca²⁺) levels, which may be disrupted after malabsorptive bariatric procedures are known to depend on gastric pH levels.

Objectives: To determine the effect of proton pump inhibitors (PPI) on Ca²⁺, parathyroid gland hormone (PTH) and vitamin D levels after sleeve gastrectomy (SG).

Methods: All patients who underwent SG between 2008 and 2013 were enrolled in our follow-up program. The patients were examined preoperatively and then four times during the first year. Ca²⁺ metabolism and weight parameters were monitored. All the patients received 3000 mg of Ca²⁺ carbonate (equivalent to 1200 mg of Ca²⁺), 800 IE of vitamin D, as well as one multivitamin tablet daily. All the parameters were then analyzed for associations with PPI intake.

Results: Data of 385 out of 400 (96.2%) patients were analyzed after 1 year of follow-up (3.8% lost to follow-up). Thirty nine (10.1%) patients took PPI for at least three months during the first year. The Ca²⁺ levels were significantly lower (p<0.0001) in the PPI group in comparison to the non-PPI group, although neither of the groups showed hypocalcaemia. The PTH levels showed an opposite behavior (p<0.0001).

Conclusions: Our data show that higher gastric pH levels caused by PPI intake negatively influence Ca²⁺ absorption. Therefore, Ca²⁺ and PTH levels should be monitored, especially in patients receiving PPI therapy after SG.

Biography:

Abstract:

Statement of the Problem: Pakistan has an estimated 7.9 million people affected with DM according to IDF and this number is expected to increase to 15.1 million by the year 2040. Landmark trials on DM prevention like DPP, Finnish Diabetes Prevention Study and Da Qing IGT study proves that type 2 DM can be prevented substantially with the help of life style modification. To implement such a trial in Pakistan is need of an hour since due to non-availability of national health system in the country there is tremendous pressure on individuals, families and community to deal with the long term complications of DM. The life style intervention trial conducted for the prevention of type-2 DM is funded by IDF.

Methodology & Theoretical Orientation: Before the intervention, baseline data was collected from the two main sub towns of Karachi, the largest city of Pakistan and also among the world’s largest and densest cities with a population exceeding 23 million. The population of Karachi is cosmopolitan consisting of diverse ethnic and cultural groups residing in areas with different city plans. The analysis reported here is a part of the baseline data collected for screening of individuals for the presence of risk factors for development of type 2 DM. The survey was conducted on 15,215 people between 30-64 years of age in urban households.

Findings: The prevalence of overweight and obesity was found to be quite high in Pakistani population (35.2 and 33.1, respectively). The prevalence of pre and unrecognized DM was also found to be high 31% and 12%, respectively. 34.4% of the participants in an intervention arm showed reversal of pre diabetes in comparison to 22.2% in control group after one year of life style intervention.

Conclusion: The trial shows increased burden of obesity and overall glucose intolerance in Pakistani population.

Biography:

Priyanga Suriyamoorthy is currently working as Assistant Professor at the Department of Biochemistry, Karpagam University, India. She holds a PhD degree in Biochemistry. She has special interest in the area of natural product research and diabetes.

Abstract:

Despite extensive progress in the treatment of diabetes by oral hypoglycemic agents, search for newer drugs continues because the existing synthetic drugs have several limitations. Previous studies carried out at our laboratory and others have reported the hypoglycemic effects of M. uniflorum in STZ induced diabetic rats. The present study is aimed to evaluate the effect of ethanolic extract of M. uniflorum leaves and isolated compounds in the regulation of adiponectin in vivo and in vitro, in order to delineate the effect of this plant on adiponectin expression in diabetes. The plasma adiponectin levels were decreased in the diabetic rats. This is associated with reduced adiponectin mRNA expression in adipose tissue of STZ induced rats. Treatment with the ethanolic extracts of M. uniflorum up-regulated the expression of adiponectin. To identify and delineate the individual compounds responsible for enhancing adiponectin levels, the extract was subjected to fractionation and nine compounds were isolated and screened using molecular docking analysis. From these results, four compounds were selected for in vitro analysis. The crude extract and four compounds were used to assess cytotoxicity through MTT assay in 3T3-L1 cells. Based on the results obtained from cell proliferation assay the crude extract, CPD 7 and CPD 8 exhibited significant proliferative effect when compared with control cells. Two compounds and crude extract were further chosen to study the expression of adiponectin gene pattern using 3T3-L1 cells. The adipocytes treated with ethanolic leaf extract of M. uniflorum (1 µg/ml and 10 µg/ml), CPD 6 (50 µM and 100 µM), CPD 7 (50 µM and 100 µM) and Glibenclamide (50 µM and 100 µM) for 48 hours exhibited up-regulation of adiponectin mRNA expression as compared with control cells. These results demonstrate that the hypoglycemic effect of M. uniflorum may be mediated through enhanced adiponectin levels.

Biography:

Nathania Sutandi is a Medical student from University of Indonesia. She intercalated in Master of Research (MRes) in Cancer at Newcastle University, UK between her 3^rd and 4^th year of study. She had worked at Hepato-biliary and Pancreatic (HPB) Surgery and Transplant Department in Freeman Hospital, Newcastle, UK for 6 months. She has particular interest in pancreatic neuroendocrine tumor (pNET).

Abstract:

Statement of the Problem: The incidence of pancreatic neuroendocrine tumors (pNETs) has gradually increased over the last three decades. As most pNETs are relatively small and solitary, they may be considered well suited for surgical removal by minimally invasive approach. Over the past few decades, robotic distal pancreatectomy is being used increasingly in specialized pancreatic surgery centers. Until now, no studies have reported the safety and feasibility of robotic distal pancreatectomy (RDP) in the management of pNET. The aim of our study was to perform the first study, which compares the outcomes of robotic versus open (ODP) and laparoscopic (LDP) distal pancreatectomy in pNET treatment.

Methodology & Theoretical Orientation: Patients’ baseline characteristics, intra-operative data and post-operative data for LDP and RDP were collected prospectively whereas ODP was collected retrospectively. All procedures performed during a 9-year period (2007-2017) were compared with RDP introduced as our standard approach in 2014.

Findings: In total, 33 patients (age range 17-76 years) underwent distal pancreatectomy with the indication of pNET. Conversion rates for LDP and RDP were 2/14 and 0/10 respectively. Docking and robotic set-up took an additional 47 minutes (range 20-75). Complications were graded according to the Clavien-Dindo classification and pancreatic fistulas were graded according to ISGPF classification. There were no mortalities in this study. Results are expressed as mean values or percentages.

Conclusion & Significance: Robotic distal pancreatectomy has unique advantages over laparoscopic and open approach in the management of pNET and should be considered where appropriate surgical expertise exists. Its safety and feasibility are comparable with the other two techniques as shown by the lower trend in blood loss, similar R0 resection rate, lower post-operative diabetes mellitus, lower high-grade complication and lower high-grade fistula. The major disadvantages are the increased cost and operative time.

Biography:

Lynn Ge-Zerbe is a recipient of the Leading Physician of the World and Pinnacle Professional of the Year 2017 award. She is board certified in Endocrinology and Internal Medicine, the Owner of Boise Thyroid & Endocrinology PC, a concierge endocrinology and weight loss practice, the Principle Investigator of Advanced Clinical Research, a Consultant Endocrinologist with RubiconMD and Video Medicine. She has earned her MD at PUMC, MPH of Epidemiology at University of Pittsburgh, Post-doctoral Fellowship in Molecular Medicine at NIH, Residency in Internal Medicine at Leigh Valley Hospital, Penn State University, Fellowship in Endocrinology at Vanderbilt University as well as Age Management Certification by AMMEF. She is passionate in combining east and west medicine to cure and prevent endocrinology disorders.

Abstract:

Rising and epidemic rates of obesity in many parts of the world are leading to increased Suffering and economic stress from diverting health care resources to treating a variety of Serious, but preventable, chronic diseases etiologically linked to obesity, particularly type 2 Diabetes mellitus and cardiovascular diseases. The incidence of diabetes mellitus has tripled Over recent decades, with an estimated 177 million people affected worldwide. It is speculated That by the year 2030 the prevalence of diabetes will increase to 4.4% worldwide (from 2.8% in 2000) with more than 300 million diabetic adults. Regarding the young population, epidemiological studies show an alarming increase in the incidence of diabetes mellitus type 2.The WHO has declared excessive weight as one of the top 10 health risks in the world and has estimated that the number of overweight people in the world is now greater than the number of undernourished. The etiology of the obesity epidemic has been partly attributed to alterations in food intake, with the prevalence of a Westernized-style diet characterized by high caloric uptake as well as a lack of physical activity representative of a sedentary lifestyle. However, the mechanisms still remain unclear, and except for a genetic predisposition and lifestyle modifications, scientific research implies the impact of environmental substances in the generative roots of obesity. “obesogens” in reference to molecules that inappropriately regulate lipid metabolism and adipogenesis to promote obesity. The rise in the incidence in obesity matches the rise in the use and distribution of industrial chemicals that may be playing a role in generation of obesity, suggesting that endocrine disruptors (EDCs) may be linked to this epidemic. Based on the links between EDCs and disturbances of reproduction, metabolism, and links to adult dysfunctions and cancer, it is reasonable to propose a connection between EDCs and diabetes as well as prediabetic disturbances. Rising and epidemic rates of obesity in many parts of the world are leading to increased suffering and economic stress from diverting health care resources to treating a variety of serious, but preventable, chronic diseases etiologically linked to obesity, particularly type 2 diabetes mellitus and cardiovascular diseases. The incidence of diabetes mellitus has tripled Over recent decades, with an estimated 177 million people affected worldwide. It is speculated that by the year 2030 the prevalence of diabetes will increase to 4.4% worldwide (from 2.8% in 2000) with more than 300 million diabetic adults. Regarding the young population, Epidemiological studies show an alarming increase in the incidence of diabetes mellitus type 2.ô€€€ô€€€The WHO has declared excessive weight as one of the top 10 health risks in the world and has estimated that the number of overweight people in the world is now greater than the number of undernourished. The etiology of the obesity epidemic has been partly attributed to alterations in food intake, with the prevalence of a Westernized-style diet characterized by high caloric uptake as well as a lack of physical activity representative of a sedentary lifestyle. However, the mechanisms still remain unclear, and except for a genetic predisposition and lifestyle modifications, scientific research implies the impact of environmental substances in the Generative roots of obesity. “obesogens” in reference to molecules that inappropriately regulate lipid metabolism and adipogenesis to promote obesity. The rise in the incidence in obesity matches the rise in the use and distribution of industrial chemicals that may be playing a role in generation of obesity, suggesting that endocrine disruptors (EDCs) may be linked to this epidemic. Based on the links between EDCs and disturbances of reproduction, metabolism, and links to adult dysfunctions and cancer, it is reasonable to propose a connection between EDCs and diabetes as well as prediabetic disturbances. 

Biography:

S Chhabra is a Director Professor of Obstetrics and Gynecology in the College of Mahatma Gandhi Institute of Medical Sciences, India and CEO of Akanksha Shishu Kalyan Kendra and OSD in Dr. Sushila Nayar Hospital, Sewagram.

Abstract:

There is a lot of information about polycystic ovarian syndrome in adolescents, young women but scarce about PCOS in adult, perimenopausal women. Symptoms vary because of multiorgan/multisystem involvement. Hirsutism, menstrual irregularities, male-pattern balding, acanthosis nigricans, sleep apnea obesity, insulin resistance, hyperinsulinemia, polycystic ovaries, overproduction of ovarian androgens, luteinizing hormone are common, with risk for hypertension, cardiovascular disease, diabetes mellitus, endometrial carcinoma. Some researchers believe that PCOS disappears around menopause, but it is not. PCOS might persist or occurs in adult perimenopasual women. May be it is an autosomal dominant disorder with hypersensitive intra-ovarian-insulin-androgen signaling disturbances, hyperandrogenism and reduced insulin sensitivity. Hyperinsulinemia stimulates lipid storage, alters triglycerides, low-density lipoprotein and cholesterol. Sex hormone binding globulins are elevated. Elevated serum leptin and insulin with obesity suggest linkage. Relation with anti-Mullerian hormone which might be responsible for abnormalities has not been studied well. Obesity is of android type with waist-hip ratio >0.8. It is more difficult to diagnose, because menstrual abnormalities are common and PCO might not be present. Fasting glucose insulin ratio is popular diagnostic. Etiology is not known, prevention has limitations. Therapy is symptomatic mainly preventive. Not much is known about efficacy of oral contraceptive pills in adult and perimenopausal women. Insulin-sensitizing agents might ameliorate IR, endocrine, metabolic abnormalities. Metformin does not increase insulin secretion, chances of hypoglycemia. Education about prevention of obesity, diabetes, cardiovascular, endometrial cancer helps. Weight loss helps in many ways. Long-term follow-up is essential.

Biography:

Seyedeh Fatemeh Vasegh Rahimparvar is an Assistant Professor in Midwifery Department of Nursing and Midwifery School of Tehran University of Medical Sciences, Iran.

Abstract:

Introduction & Aim: Women with recent gestational diabetes mellitus (GDM) are at elevated risk for developing type-2 diabetes. Despite the recommendation for postpartum diabetes screening in these women, the rate of the screening is low. The objective of this study was to conduct the experiences of Iranian women with recent GDM on process of diabetes screening.

Methods: This qualitative study was conducted in Tehran, Iran in 2016. 22 women with recent GDM, who gave birth a minimum of 6 months before interview was selected by purposeful sampling method. The women were asked about their experiences about the process of attendance/not attendance in diabetes screening at 6 weeks to 6 months after child birthing by using semi-structured interviews. The data was analyzed by using grounded theory method.

Findings: Three main categories were extracted as postpartum diabetes screening process in women with a recent GDM, including “to be aware”, “to be sensitive” and “to perceive the severity of the threat”. Also the outcomes have been classified into four levels: Selective screening, accidental screening, primary lack of screening, and secondary lack of screening. In our study, the participants had a range of procrastination in the screening from no procrastination in selective screening to high procrastination in secondary lack of screening. Sometimes the participants had intention to the screening but without action, did not do the screening due to self-deception and perceived the screening as lacking immediate reward (three main features of procrastination); so due to procrastination, they did not do the screening. Screening in the range of procrastination, as the core category, was the most obvious concept that implicitly existed in all the data.

Conclusions: Even when sensitivity and perceiving of the threat about diabetes have been activated in women with recent GDM, procrastination may cause the women not to undertake the screening.

Biography:

Juan C Calderon is a Medical Doctor, completed his PhD in Physiology. He is devoted to understand different functions of skeletal muscle. His work has been related to excitation-contraction coupling, calcium signaling and muscle fatigue.

Abstract:

Myokines regulate metabolism in different tissues. Musclin is a myokine secreted by muscle fibers type II (FT-II). Since musclin induces insulin resistance (IR) in vitro, it could be associated to IR in patients within metabolic syndrome (MS). We aimed to evaluate the relationship between serum musclin, IR, muscle mass and area of FT-II in humans with and without MS. Patients with (n=23) and without (n=10) MS, comparable in age and sex were recruited. Medical and anthropometric assessments, biochemical tests, serum musclin measurements by ELISA, global and regional muscle mass determination by dual X-ray absorptiometry and area of FT-II in right vastus lateralis muscle estimation by proton magnetic resonance spectroscopy were performed in all patients. Muscle mass indexes for global and right thigh muscle mass (Kg muscle mass/m², Kg muscle mass/Kg body mass, Kg muscle mass/Kg fat mass) were also calculated. Homeostatic model assessment as an indicator of IR was calculated as: HOMA-IR=((glycemia (mg/dl)/18)*insulin(µU/ml))/22.5. Patients with MS had more IR than control subjects (HOMA-IR 4.6±2.2 vs. 1.6±0.6; mean±standard error; P<0.05). There were no differences in circulating musclin or in absolute muscle values or muscle mass indexes between groups. Positive correlations between IR and both total and thigh fat mass (r>0.46; P<0.05) were obtained. Also, positive correlations were found between musclin and total and thigh muscle mass (r>0.51; P<0.05). Area of FT-II was positively associated to muscle mass indexes (r>0.49; P<0.05). We found an inverse tendency between IR and muscle mass (r -0.34; P=0.07), but we did not observe a correlation between IR and musclin. In conclusion, muscle mass was associated to the concentration of circulating musclin, however musclin was not associated to the degree of IR in patients with and without MS. These findings conflict some previously reported in other experimental models.

Biography:

I am Dr Christy Vijay, a recent graduate having finished my undergraduate Bachelor degree of medicine in St. Johns National Academy of Health Sciences, Bangalore. I am recently doing my rural bond at Solur, (Karnataka, India) Obstetrics and Gynaecology Maternity Centre, (which is a rural service programme to serve the backward and underserved areas of the country, which is the mission of our hospital).  I have recently published two papers in two journals (one national and the other international).

Abstract:

Introduction & Aim: Insulin is essential for the normal carbohydrate, protein and fat metabolism in the body. The deficiency of this hormone leads to a metabolic disorder called diabetes mellitus. There has been an increase push for early initiation of insulin in routine diabetes care. Insulin therapy presents with many challenges due to the complexities associated with use. Insufficient knowledge of its use can result in preventable complications, adverse patient outcome, poor adherence to therapy and invariably poor glycemic control. Our project is aimed at determining the level of awareness among the insulin taking populations both urban and rural about insulin and the methods of insulin administration, storage and disposal.

Method: This study was a cross-sectional study and the study participants were 100 patients coming to St. Johns’ Medical College Hospital both inpatients and outpatients. A self-administered standardized questionnaire was used to collect the data. The tool assessed knowledge on administration, storage, usage and disposal of insulin.

Result: Our study included a total of 100 patients of which 59 were males and 41 females. The participants were patients/attendees that were present in a tertiary care hospital in Bangalore, India. The majority of the population belongs to an urban/peri urban background. Majority of our participants 57 (57%) were found to have inadequate practice when compared to those who had adequate.

Conclusion: The knowledge among the insulin using participants was inadequate, indicating the need for better awareness programs among the health professionals. Proper instructed teaching to the user at the time on initiation.

Biography:

Manjeet K Sharma, as a Biochemist specialized in Neurochemistry, ascertained the effects of psychotropic drugs on catecholamines in brains of inbred mouse strains and established that behavior and drug responses have a genetic basis. As Neuroendocrinologist, she established in vitro and in vivo animal models (rodent and primate) and focused studies on feedback regulation of reproductive hormones and regulation of spermatogenesis at a molecular level by hypophyseal and gonadal, protein and steroid sex hormones. She retired as Head of Neuroendocrinology Department, National Institute for Research in Reproductive Health, India.

Abstract:

Diabetes mellitus (DM) is a disease of the peripheral organs while Diabetes Insipidus (DI) is a disease of the brain. Both forms of diabetes are characterized by excess levels of blood sugar or glucose. Whereas the former is due to insulin resistance or insufficiency the latter is due to insufficiency of vasopressin (VP) or hypophyseal anti-diuretic hormone (ADH). But the causes underlying the accumulation of glucose in circulation are different in the two types of diabetes. Diabetes mellitus is of two types. While type-1 diabetes (T1D) is due to autoimmune destruction of insulin-producing cells viz. pancreatic islets of Langerhans (IL), type-2 diabetes (T2D) is a lifestyle disease due to exhaustion of IL to produce insulin. Whereas glucose fuel unavailability in the mitochondria leads to deficit of energy production in the form of ATP, its accumulation in blood leads to complications due to inflammatory damage to blood vessels. Recently, Alzheimer’s disease (AD) has been hypothesized to be type-3 diabetes (T3D), caused by insulin resistance in the brain, an organ absolutely dependent upon glucose as fuel for ATP biosynthesis. Whereas AD and DM are characterized by dementia and cognitive decline respectively, their known cellular biomarkers are different namely neuronal amyloid peptide (βAP), Tau, glial TDP-43 for AD and islet amyloid polypeptide (IAPP) for DM. DM also has a genetic component namely HLA-DQB1, CTLA-4, INS genes. Biomarkers of AD need to be demonstrated in mouse and human models of DM before dementia of AD can be equated with cognitive decline of DM and therefore of lifestyle and dietary origin and essentially reversible, for it may have additional yet unknown causes.