31^st European Diabetes Congress March 16-17, 2022 London, UK

Biography:

Deanna Mulvihill has her expertise in evaluation and passion in improving the health and wellbeing. Her open and contextual evaluation model based on responsive constructivists creates new pathways for improving healthcare. She has built this model after years of experience in research, evaluation, teaching and administration both in hospital and education institutions. The foundation is based on fourth generation evaluation (Guba& Lincoln, 1989) which is a methodology that utilizes the previous generations of evaluation: measurement, description and judgment. It allows for value-pluralism. This approach is responsive to all stakeholders and has a different way of focusing.

Abstract:

Introduction: Diabetes is a chronic disease associated with many comorbidities and a higher risk of mortality. Patients are constantly in the lookout for Complementary and Alternative Medicines that are safe and efficacious for type 2 diabetes management. Objectives: The primary outcome was to evaluate the effect of GlucoLo Plus on HbA1c and the secondary outcome was to assess the effect on bodyweight and it’s innocuity.

Methodology: This double-blind randomised placebo-controlled trial evaluated the effects of daily GlucoLo Plus, a newly formulated all natural supplement for diabetes type 2 management.

Results: Of 64 individuals assessed for eligibility, 61 (mean HbA1c 6.98% [52.8 mmol/mol], mean age 67.3 years [SD 9·5], 26 [43%] women, mean diabetes duration 3.2 years, and mean body-mass index 27·9 kg/m2) were randomly assigned to GlucoLo Plus (n=32 [53%]), or placebo (n=28 [47%]). 1 participant was lost to follow up. At 12 weeks, GlucoLo Plus decreased HBa1c by 0.83% (P=0.0131) while placebo reduced it by 0.12% (p = 0.6151). The GlucoLo Plus arm had a mean 1.84 lbs weight loss while the placebo arm had a 0.21 lbs weight gain. The most frequent adverse events with GlucoLo Plus were mild and transient gastrointestinal events including nausea (9.3% vs 3.5%) and dyspepsia (15.6% vs 10.7%).

Conclusion: GlucoLo Plus significantly lowered the HbA1c, had a positive effect on bodyweight and had a minimal side effect profile. These results suggest that GlucoLo Plus could be an alternative and adjunct to type 2 diabetes in people who are reluctant to initiate or add new antidiabetic agents.

Biography:

Asmaa Namoos is a Doctoral Student in the Department of Health Behavior and Policy at Virginia Commonwealth University ‘s School of Medicine. She holds an M.D. from Alexandria University in Egypt and a Master’s in Public Health from George Washington University, Washington, D.C. Her research interests include health disparities and disease control among Muslim women.

Abstract:

Introduction: During the COVID-19 pandemic people have been doing less exercise due to stay-at-home mandates and gym closures in the state of Virginia. Physical activity is a simple health determinant to prevent obesity and diabetes.

Methods: This research is using electronic medical records to compare BMI rates during the COVID-19 pandemic and prior years. The project also investigates whether it has been more difficult to manage existing
diabetes disease and if there are more newly diagnosed diabetes cases during the COVID-19 pandemic, compared to previous years, with special focus on racial minorities served by the Virginia Commonwealth
University Health System.

Result: The BMI cohort there is an increase from 2018 to 2019 but a decrease in 2020. For the Diabetes cohort, the mean Hba1c increases from 2018 to 2020. However, the number of emergency department visits declined in 2020. When stratified by race, the trends in the outcomes largely reflect those of the overall mean.

Conclusions: The African American population had a higher mean BMI, HbA1c and number of ED visits then other races, but showed the same temporal behavior to the overall mean.

Biography:

Gianina Ioana Constantin is a senior scientific researcher and medical principal chemist in medical biochemistry specialization; expertise in biology of aging. Research fields: the study of the biochemical, immunological, cellular and molecular mechanisms in normal and pathological aging; research on establishing criteria for assessing the biological age and the rate of aging of the individual. She is author and co-author in over 43 scientific papers published, 145 scientific papers international congresses, 61 scientific papers national congresses, 6 national research programs, 1 FP7 - Health international program and member of OBBCSR and Romanian Society of Gerontology and Geriatrics.

Abstract:

Background: Diabetes is a chronic condition that results in excessive blood sugar circulation, which can lead to disorders of the circulatory, nervous, and immune systems.

Many studies have shown that myeloperoxidase (MPO), a heme protein released by leukocytes, is involved in the process of oxidative stress and plays an important role in the initiation and progression of acute and chronic inflammatory diseases, suggesting a positive correlation between activation of MPO and metabolic disorders.

Purpose: Our study was proposed to assess levels of myeloperoxidase in two groups of elderly patients (69.15 ± 7.33 years): a group of control patients and a group of patients with type 2 diabetes.

Methods: MPO levels were determined in serum by immunoenzymatic assay and spectrophotometric detection at 450 nm.

Results: In this study, serum MPO concentration was demonstrated to be significantly higher in diabetic patients compared with non-diabetic group (625 ± 252.83 vs 436.66 ± 89.62 ng / ml serum).

Conclusions: In conclusion, patients with type 2 diabetes had increased serum MPO levels, wich proves that MPO, being an pro-inflammatory enzyme, can be considered an early biomarker and indicator for inflammation associated with metabolic disorders in diabetic patients.

Biography:

Sophie Walker was awarded a 1st class MChem BSc in Chemistry with year in industry from the University of Leeds (2015-2019). Following on from undergraduate studies, she moved to the University of Edinburgh Centre for Cardiovascular Science at the Queen’s Medical Research Institute to study for a MSc (2019-2020) and PhD (2020-present) funded by the British Heart Foundation. Here, she is studying to optimize islet transplantation for the treatment of type 1 diabetes through the use of microparticles to modulate the liver niche, working under the supervision of Prof. Shareen Forbes, Dr Mairi Brittan, and Dr Lisa White (University of Nottingham). This work will hopefully allow for a greater insight into the effect of the liver niche on the survival of islet cells when transplanted via hepatic portal vein injection and aim to provide information to aid the continued development of the procedure with its translation into a clinical setting

Abstract:

Clinical islet transplantation for Type 1 diabetes (T1D) is performed using ultrasound guidance (US) via percutaneous trans-hepatic portal venous access. Injection of islets and other substances into the hepatic portal vein (HPV) of mice using open laparotomy techniques are commonplace when researching T1D therapies. However, this procedure is invasive, leads to longer recovery times and increases potential for infections. Techniques using open laparotomy do not resemble procedures seen in clinical settings. US injection into the HPV mostly negates the above concerns, and better emulates clinical methods of islet transplantation in humans.

Hypothesis: US methodologies will refine surgical procedures, improving recovery and welfare of animals, whilst seeing the same number and distribution of cells/markers as when using open laparotomy surgical techniques.

Methodology: US and open laparotomy HPV injections were performed in female C57Bl/6-mice and US HPV injection was performed in male RNU-rats (injecting 0.1 mg of 20 um fluorescent PLGA microparticles to aid analysis). Tissues were cryopreserved at 24 hours post-transplant and subsequently cryo-sectioned. DAPI staining alongside the fluorescent microparticles allowed for the quantification of microparticles in the liver tissues following each surgical technique.

Results and Conclusions: US injection results in a significant reduction of microparticles in liver tissues, when compared to open laparotomy surgical techniques. Clustering of microparticles around the edge of tissues is seen in animals having undergone US techniques, suggesting that microparticles are residing where the needle is being withdrawn through the liver or accumulating around tissues if the injection releases into the body cavity. Locating and accurately injecting into the HPV using ultrasound guidance may hinder the success of transplants in rodent models. Reflux of some microparticles out of the vein where the needle is inserted is seen upon commencement of the injection.

US HPV injection is therefore not a robust or reliable method for such studies.

Biography:

Vanessa Silverio is a Family Nurse Practitioner, currently working in a direct primary care practice in Merrillville, Indiana. She will be earning a Post-Master’s DNP from Valparaiso University in May 2022.

Abstract:

Type 2 Diabetes Mellitus (T2DM) is a chronic disease characterized by increased amounts of glucose in the blood. Despite evidence about the effectiveness of oral anti-diabetic (OAD) medications in combination with lifestyle changes to improve glucose control, many diabetics are non-adherent to their treatment regimen, leading to life-threatening health consequences. The purpose of the evidence-based practice project (EBP) is to identify the most effective intervention for improving medication adherence, lifestyle changes, and hemoglobin A1C (HbA1c). A literature review was conducted within five electronic databases, which generated eight moderate to high leveled evidence studies that support tailoring daily text messages to individuals to improve medication adherence and glucose control. Participants were recruited in a primary care practice in Northwest Indiana. Eligible participants included adults aged 18 to 70 years old, with a diagnosis of T2DM with HbA1c greater than 7, taking OAD medications. Participants will complete the Medication Adherence Report Scale (MARS-5) questionnaire to assess medication adherence before and after the twelve-week intervention. HbA1c will be collected prior to and after the intervention. Participants received daily text messages at medication dosing times and tailored text messages twice weekly for the first month, and once weekly for the second and third months focused on healthy eating habits and exercise. Key stakeholders involved will be the nurse practitioner, medical assistant, registered nurse, and T2DM participants. A paired t-test compared pre- and post-intervention MARS-5 scores. The proposed primary outcome is an improvement in medication adherence and lifestyle changes. The secondary outcome is a lower HbA1c. Further research is needed to assess the longitudinal effects of tailoring text messages after 12 months to improve medication adherence. In the short term, providing tailored text message reminders to take medication and encourage lifestyle changes may be applicable to any chronic disease needing long-term medication therapy.

Biography:

Abstract:

Background: It is known that triglyceride-glucose index (TyG) has high sensitivity for insulin resistance and is closely associated with metabolic syndrome and diabetes mellitus type 2 (DM) development.

Aim: The purpose of the study was to establish the correlation between TyG and lipid modification in the DM development.

Material and method: Present work included 79 elderly patients: 49 DM and 30 healthy control patients.

Findings: Data revealed an increase of triglycerides, cholesterol, non-HDL-cholesterol (p<0.0001; p<0.05; p<0.0001), and a decrease of HDL-cholesterol (p<0.0001) at DM patients vs. control. As for TyG, DM patients have also high levels vs. control (p<0.0001). The linear regression equations showed a significant positive correlation of glucose with: HbA1c, non-HDL-cholesterol, triglycerides and negative correlation with HDL-cholesterol; also a significant positive correlation of HbA1c with triglycerides at DM patients. For TyG linear regression revealed a positive significant correlation with HbA1c, cholesterol and non-HDL-cholesterol at DM patients. Diagnostic test evaluation for TyG indicated: 88.61% assay accuracy, 85.71% sensitivity, 93.33% specificity, 62.03% disease prevalence and relative risk estimate=4.77. Multivariate logistic regression analysis showed that patients with high TyG are 84 times more likely to have diabetes compared to those with low TyG [OR 84, 95% CI: 16.25-434.17; p<0.00001].

Conclusions: There is a strong direct correlation between TyG and DM, the higher TyG the more likely it is to develop DM. Also TyG is positively associated with lipid status. TyG could be more reliable than glycemic/lipid parameters and could be used in identifying patients at borderline or apparently healthy.

Biography:

Abstract:

Diabetic Retinopathy (DR) is widely regarded as one of the most prevalent and perilous consequences of diabetes. Currently 145 million people suffer with DR, and 45 million with sight-threatening DR. These numbers are expected to exceed 224 million and 70 million respectively by 2040.

DR occurs when the diabetic condition damages blood vessels in the retina, where the undiagnosed sufferer remains unaware of the condition; often until irreparable. DR has been confirmed as the most common form of diabetic eye disease and the leading cause of blindness in adults aged 20–74.

Fortunately, the risk of diabetic blindness can be reduced by 95% with early detection and timely treatment. Unfortunately, early diagnosis poses one of the greatest challenges as determining the precise stage of DR is notoriously difficult requiring specialised human interpretation of fundus images. Timely and accurate streamlining of this diagnostic process is crucial to future reduction of the growing cases of DR blindness. This research investigates the use of Artificially Intelligent (AI) Convolutional Neural Networks (CNNs) to achieve precise DR diagnosis.

A CNN is a powerful image processing technique that uses Deep Learning (DL) to perform both generative and descriptive tasks, often using Machine Vision (MV) that includes image and video recognition. The use of CNNs is not new to the field of DR, however progress using such techniques is frequently hampered by the expense to the patient, patient wait times, and limited availability of medical professionals to perform the analysis.

A unique combinational CNN model for efficient and accurate fundus image identification was developed by combining image normalisation with a bespoke CNN comprising optimal minimal layers. The presented model was built on top of the Densenet-121 Architecture of CNNs, with additional layers for Global Average Pooling, Dropout, and Sigmoid Activation. Two datasets were used to train the CNN for peak performance achieving a Quadratic Weighted Kappa score of 0.8772 and validation accuracy of 93.96%.

Post training experiments using the custom-built CNN model were conducted using 7 retinal scan images depicting the current retinal health of the diabetic participant. The participant’s independent physician provided a medical report testifying the participant presently had zero DR. This report provided an irrefutable measure of success for model prediction. Results showed that the model achieved 100% accuracy returning a zero DR diagnosis for the participant, thus surpassing the validation accuracy

Biography:

Abstract:

The aetiology of Type I diabetes (T1D), an immune condition that leads to the destruction of pancreatic beta cells producing insulin, remains elusive. Previous studies suggest that genetic predisposition plays a role, with genome-wide association studies (GWAS) reporting associations to the HLA-DQA1, HLA-DQB1, and HLA-DRB1 genes. Here we studied a well-defined patient cohort diagnosed with T1D (n=25), Systemic Lupus Erythematosus (SLE, n=25) and Juvenile Idiopathic Arthritis (JIA, n=25) recruited in the city of Barranquilla, Colombia. Whole exome sequences of 75 patients were contrasted against a manually-curated list of previously reported genes predisposing to autoimmune diseases in worldwide populations. Single- and multi-locus linear mixed-effects models were used to identify T1D-associated genomic variants when contrasted to other phenotypes. Significant associations to T1D were harboured in genes related to biosynthesis of glycoprotein oligosaccharides, phospolipid binding, pancreatic adenocarcinoma, systolic blood pressure and fasting insuline, among others, including MGAT5 (PFDR=1.64x10-22), RUNX1 (PFDR=1.8x10-12), PSD3 (PFDR=8.1x10-12) and HLA-DBP2 (PFDR=2.18x10-9). Other significantly associated variants were harboured in the GRB2, GABRA2, CD86, KSR2 and EDEM3 genes. Interestingly, some of these variants were also present in individuals with SLE and AIJ. Sharing of these genomic variants by two or more autoimmune diseases provides supporting evidence towards the existence of the autoimmune tautology in this understudied population. Future studies are needed to evaluate their implication in the aetiology of T1D and their feasibility for developing Machine Learning to enable precision medicine tools for diagnosis and follow-up.

Biography:

Abstract:

Herbal drugs are usually incorporated plant formed mixture in the treatment of diabetes and other disease in Ayurveda and their reported side effects are very less and cost effective. Type 2 diabetes is a condition of insulin insensitivity or the state of resistance of insulin which leads to impairment of glucose utilization. Debix an Ayurved herbal drugs mixture was provided to manage the newly diagnosed diabetes in otherwise healthy 33 years old male with no history of any other disease or medication, on continuous 4 months of treatment plus recommendation to adopt life style modification and 30 minutes of exercise the patient exhibited normal blood glucose report as well as HbA1c was quite improved and finally reached at normal percentage. This sort of data in Ayurveda clinical case study is scarcely reported and published means no report is generally made in scientific way in Ayurveda hence this case presentation will be beneficial to the Ayurveda practitioner.

The rationale of this case report is, basis of treatment in Ayurveda can be commenced in newly diagnosed diabetes by Debix, a proprietary Ayurvedic medicine manufactured by Sandu pharmaceutical Pvt.Ltd without any report of side effects under continuous supervision, at least for four months to fully manage the case.

Biography:

Abstract:

Aging is the predominant risk factor for chronic diseases, such as type 2 diabetes (T2D), that affect quality of life and longevity. However, organismal chronological age is not synonymous with biological age, and evidence suggests that different organs, within the body, age at different rates, depending on the unique cellular properties and function of the organ. Furthermore, the physiological demands on an organ, such as the demands on the pancreas from metabolic stress induced by obesity and T2D, may also influence the rate of aging. T2D is partly characterized by dysfunctional insulin secretion from pancreas islets and the continual functional decline in the compensatory increased pancreatic β-cell proliferation (i.e., mass) in response to increased blood glucose levels. Aging, itself, leads to increased blood glucose levels, resistance to insulin, decreased metabolism, and limited exercise capacity, which also contributes to weight gain and obesity, but it is the inability of the pancreas to compensate for insulin resistance that determines whether T2D develops. Although lifestyle changes, such as physical exercise and body mass index maintenance, can reverse T2D, at least temporarily, and limit some of the morbidities associated with aging, aging-related physical and mental frailty can hinder an aging individual’s ability to exercise. The exercise-induced bone-derived hormone, osteocalcin (OCN) has been shown to promote insulin secretion and to enhance pancreatic β-cell mass and function. However, bone loss and frailty in aging individuals can limit their exercise capacity, and the decreased ability to exercise coincides with the decline of OCN levels with age. This study tested the effect of OCN on pancreatic β-cell senescence expression and pancreatic islet function. Several senescence markers (e.g., CDKN2a, MAPK14, IGF1R, and CD99) have been used to identify aged β cells, but whether the aged β cells and the loss of mature cell identity can be reversed is not known. Both aging and obesity are associated with the loss of β-cell identity, defined as the failure to express pancreatic β-cell transcription factors (e.g., FOXO1, FOXA2, SUR1, PDX1, NKX6.1, PAX6, NEUROD1, PCSK1, MAFA, and UNC3), which directly regulate the transcription of insulin and are associated with β-cell function. In this study our data show that OCN decreases markers of senescence in pancreatic β-cells and restore pancreatic β-cell transcription factors which as result improves human pancreatic islet function. Our data derived from obese, non-obese, diabetic, and compared to non-diabetic function.