20^th Asia Pacific Diabetes Conference July 16-17, 2018 London ,UK

Biography:

Lan Nguyen has been working for ten years as a Nursing Lecturer in University of Medicine and Pharmacy in Ho Chi Minh City, Vietnam. She has obtained her Master of Advanced Nursing Practice in the Netherlands in 2010 with her masters’ thesis topic on quality of life and coping with diabetic foot ulcers among patients with diabetes. Currently, she is a PhD student at the Queensland University of Technology, Brisbane, Australia. Her research interest focuses on wound management and health prevention and health behavior change strategies.

Abstract:

Statement of Problem: The burden of diabetic foot ulcers is enormous and Vietnam is not exempt from this issue. Up to 85% of foot ulcers can be prevented, however, in most cases, early-stage prevention strategies have not been a focus.

Aim: The study aimed to evaluate the effectiveness of a self-efficacy theory (SET) based foot care education intervention program. The program examined foot self-care behavior and common minor foot problems among patients at low risk of diabetic foot ulcers in Ho Chi Minh City, Vietnam.

Method: A quasi-experimental design with 2 groups, using pre-and post-tests was used. From the 119 participants, 60 participants in the control group received usual care and a foot care brochure. Those in the intervention group received: 60-75 minutes of a small group intensive education and hands-on skills session; a foot care kit and documents and three regular booster follow-up phone calls over 6 months. A generalized estimating equations model was undertaken to examine the impact of the intervention on foot self-care behaviors and prevalence of common minor foot problems (i.e. dry skin, corns/callus) over 6 months from baseline after adjusting covariates.

Result: The intervention group had significantly improved outcomes compared to the control group over 6 months in the following aspects: Better preventive foot care behavior (p=0.001); decreased prevalence of common minor foot problems (i.e. dry skin, corns/callus) [OR: 0.04, 95% CI: 0.01-0.13, p<0.001). However, reduction in potentially damaging behavior was not found significantly different between groups over the study period (p=0.09).

Conclusion & Significance: The study’s findings provide evidence for the effectiveness of a theory-based education intervention on improving foot self-care behavior and preventing minor foot problems what commonly precede diabetic foot ulcers. Further study with a RCT design, in a larger sample of patients and longer follow-up time is recommended.

Biography:

Dr Ramakrishnan Santosh is a practicing clinical endocrinologist for ten years. He has 34 papers in various journals and has authored three text book chapters. He has presented in more than 400 scientific forums which include many international conferences of repute. His significant extracurricular activities include lecturing in management schools and having authored 3 fiction novels.

Abstract:

Self Monitoring of Blood Glucose (SMBG) plays an extremely important role in management of Gestational Diabetes Mellitus. The hallmark of Gestational Diabetes is the constantly changing blood glucose values till delivery due to changes in the insulin resistance. Confusion exists about the frequency of monitoring, timing of monitoring (whether preprandial or postprandial, one or two hour postprandial) and sample preferred (venous or capillary). We also review the acceptance and adherence to SMBG in various studies. In this presentation, we review the historic and the latest guidelines on the same.  Remote monitoring of blood glucose values is now possible with the use of technology. We review the different ways of doing so. We also present the improvement in compliance to SMBG, acceptability of remote monitoring of glucose and the improvements in the trend of blood glucose control in our centre using email and mobile applications as tool for the same.

Biography:

Shahjada Selim has his expertise in endocrinology especially in diabetes, obesity and sexual disorders. He has obtained his MBBS degree from Rajshahi Medical College, Bangladesh; MD (Endocrinology and Metabolism), BIRDEM Academy under Dhaka University and FACE in 2016. He is currently working as an Assistant Professor in the Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. He has more than 40 particles published in the international reputed journals. He has also published four books in Bengali on diabetes and thyroid disorders.

Abstract:

Objective: Studies have reported an inverse correlation between low levels of HDL cholesterol and increased risk of ED. To expand our knowledge on modifiable risk factors of ED within diabetic patients and dyslipidemia, we conducted a cross-sectional observational study.

Method: The study involved 813 males (20-69 years) with type-2 diabetes. Subjects were recruited from outpatient and inpatient department in Bangladesh from Bangladesh Institute of Research and Rehabilitation in Diabetes. Sexual function was evaluated with the International index of erectile function after translation into a Bengali version and validated under proper validation protocol.

Result: The mean cholesterol level of the sample was 184.5±41.5 mg/dl with 37% having levels higher than normal. Raised levels of HDL and LDL were found in 31% of subjects and elevated triglyceride levels were present in 57% of participants. The diabetic subjects with ED in the study were significantly older (p=0.000) and had suffered from diabetes for a longer duration of time (p=0.000). Independently abnormal levels of cholesterol (P=0.000), HDL (P=0.000), LDL (P=0.000) and triglyceride levels (P=0.000) all proved to be significant determinants of ED in the study population (table). Increased diabetes control was also found to be significantly associated with ED in the study.

Conclusion: Dyslipidemia was found to have the most significant risk associated with increased ED with the lipoproteins of lowered HDL and increased LDL levels demonstrating substantial influence of ED risk in diabetic patients.

Biography:

Dr. Aditya Vedula is a resident of Internal Medicine with aptitude for Diabetes and Nephrology. Hailing from India where Diabetes and Hypertension are on the rise at an alarming pace, Aditya believes in the immense necessity of primary prevention of the many dangerous complications of these two non-communicable diseases. He is undergoing residency in Sree Balaji Medical College in Chennai which conducted vast number of studies in various models involving multiple disciplines relating to diabetes and its complications.

Abstract:

Peripheral vascular disease (PVD) is a major complication and cause of morbidity in diabetic patients worldwide. Earlier detection of PVD could prove beneficial to the patients at risk. This is a prospective study done to find out whether inflammatory markers like hsCRP, Apo-A, Apo-B, homocysteine help in detecting peripheral vascular disease early. Diabetic patients for more than 3 years without other comorbid illness were included in the study. After getting the ethical committee’s approval, the selected subjects, were tested for hsCRP, Apo-A, Apo-B and homocystiene levels and doppler study of lower limb vessels were done. Of the 100 patients, only 25 patients had elevated levels of Apo-A (25%). Apo-B levels were elevated in 67 patients (67%). Highly sensitive CRP was elevated in 63 patients (63%). The mean age of the study population was 52 years and the mean duration of diabetes was 8 years. 15% of diabetic patients had normal HbA1C and did not have elevated biomarker levels. Patients were followed up for 2 years. Of patients who had elevated biomarkers, 30% developed PVD. This study shows that inflammatory markers like hsCRP, apo-A and apo-B are sensitive markers for early detection of peripheral vascular disease and thereby for reducing morbidity. Tight control of diabetes is quintessential to prevent occurrence of complications of diabetes.

Biography:

Soraya Siabani has completed her Medical Doctorate degree from Kermanshah University of Medical Sciences, Iran and her PhD from School of Medicine at the University of Sydney in Australia, early 2015. She is the Director of ACS Registry and Assistant Professor of Health Promotion in western Iran. She has published more than 20 papers in reputed journals and has been serving as an Editorial Board Member of Journal of Injury & Violence and the Journal of Education Research in Medical Sciences. Her research focuses on health education as well as the epidemiology of chronic diseases, particularly on diseases registry.

Abstract:

Aim: To test the association between the outcome of ST-Elevation Myocardial Infarction (STEMI) in diabetic and non-diabetic men and women in comparison.

Methods: This paper presents the results of a part of an on-going cohort-registry (a single centre prospective observational) study conducted in western Iran. Patients meeting the inclusion criteria; clinical history consistent with myocardial infarction; Electronic Cardiograph (EKG) demonstrating ST-elevation myocardial infarction and >18 years old- have been registered from 1^st July 2016. Those do not will to participate and those who die before data collection have been excluded. The baseline data was collected via patients’ interviewing, medical records and health information system. Using SPSS-applying descriptive statistics, t-test and logistic regression, the frequency, rates and associations between variables were estimated, whenever applied. The regressions and Odds ratios for outcomes variables were obtained adjusting for the likely contributing variables such as age.

Results: Among 925 patients recruited in the first year of study, data from 810 patients were eligible to undergo analysis for the current report. The ratio of female patients, 165 (20.4%) with the mean age of 66.15±11.30, was significantly less than male patients (p<0.0001). About 34% of women were diabetic, 63.6% hypertensive, 35.8% hypercholesterolemic and 13.9 % current smoker. The age-adjusted in-hospital death rate for women was more than two times (2.14 times) of men (p<001). The chance of in-hospital death for women has been increased by 1.04% for each year increasing their age. A significant positive linear relationship was between diabetes and death rate in all 810 patients (p=0.014, Odds=1.92). However, the variety for each group of males and females, separately, was not significant (p=0.095, Odds=1.78 for M, p=0.089, Odds=2.08 for F).

Conclusion: In western Iran, STEMI is significantly less frequent in females compared with males, however, it is extremely more health threating in females. Also, diabetes can worsen the outcomes of patients with STEMI, though the extent of this association needs more investigation.

Biography:

Dr. Komal Verma, is currently working as the Associate Professor at Amity Institute of Behavioral and Allied Sciences, Amity University Rajasthan,India

Abstract:

Diabetes mellitus  is one of the  most prevalent health problem which India is facing and self management is key component in dealing with it. Self management is considered to be individuals competency in handling situations but it is perceived to be more effective if influenced by social support. This study aims to assess the use and benefits of social media among patients with type 2 Diabetes in India as a well-being mechanism. Factorial design was used to address the study objectives. The current study reflects positive impact of usage of social media in managing type 2 diabetes, which also proves the theoretical base of social support and biopsychosocial model in managing long term illness. The results of the study adds to the current literature gap on perceived benefits of  social media use in managing diabetes and it can also help health care providers to understand the role of  social support which patients are considering to be important stakeholder in dealing with diabetes.

Biography:

Irina Kurnikova - MD, PhD, Professor of Medicine of RUDN University, Moscow, Russia. Dealing with Problems of Endocrinology for over 20 years.  Currently she is curator of the Scientific Direction Endocrinology in RUDN University.  She had published more than 30 articles in well-known journals, the author of 25 books and tutorials in Russian language, 10 patents for inventions. The main areas of research are the optimization of the system approach to the treatment and rehabilitation of patients with diabetes, thyroid diseases. The main directions of scientific research: influence of disturbances in the system of regulation of the organism and other endogenous factors (comorbidity, disruption of the mechanisms of humoral transport) on the effectiveness of treatment and the quality of compensation of diabetes and other endocrine diseases.

Abstract:

Type 2 diabetes (DT2) combined with other diseases often, which affects the features of the progression of diabetes. What mechanisms the realization of this influence is a question for study. We made a comparative analysis of the spectral characteristics of the heart rhythm of DT2 patients with concomitant diseases: 28 patients (group 1) with an arterial hypertension (HTN) and 17 patients (2) with gastrointestinal tract diseases (GIT). Comparison group (3) - 25 patients with CD2 without concomitant diseases. The power of the frequency spectrum was estimated for HF, LF, VLF, ULF, IC-centralization index. In the group 1, increase in LF and decrease in HF were observed, which is characteristic of chronic stress. ULF was higher than in the group 3 (p = 0.0002; r = 0.48), which is characteristic for the failure of vegetative regulation. In two patients from this group, the values of ULF occupied almost the entire spectrum (76% and 91%). In both cases, patients died from vascular accidents for half a year, despite active therapy with antihypertensive drugs. In the group 2, activation of central ergotropic and humoral metabolic processes was observed, exceeding the value in the group 3 (p = 0.001; r = 0.37). This indicator demonstrates the practically direct effect of HTN on metabolic homeostasis, explains the reasons why it is difficult to achieve compensation of DT2 with concomitant hypertension, and explains one of the mechanisms of progression of complications of diabetes. The increase IC in the group 2 confirmed the high activity of the central contour of regulation in relation to the autonomic. Moreover, this, in prognostic terms, indicated the depletion of regulatory mechanisms and a high risk of developing "vascular accidents" (OR = 2.7, p = 0.001).In the group 2, the directionality of the regulatory processes indicated chronic stress also.

Biography:

Nisha Nangrani is a final year medical student at James Cook University in Townsville, QLD, Australia. As part of her Bachelor of Medicine/Bachelor of Surgery (MBBS) Honours Research project, she has joined the team at Translational Research in Endocrinology and Diabetes (TREAD) at James Cook University. TREAD has recently commenced the Telehealth for Diabetes Project which aims at making healthcare more accessible to patients suffering from diabetes in rural and remote North Queensland. She is guided and supervised by Dr Usman Malabu, Consultant Endocrinologist at the Townsville Hospital and Dr Venkat Vangaveti, Senior Research Officer at James Cook University.

Abstract:

Background: The outcomes of telehealth in the management of Type 2 diabetes (T2DM) have not been evaluated since the publication of recent clinical trials. The objective of this study is to conduct a systematic review and meta-analysis of recently published randomized controlled trials (RCTs) to assess the biochemical, clinical and psychosocial outcomes of telehealth in subjects with T2DM.

Methods: Electronic databases, MEDLINE, CINAHL, INFORMIT, SCOPUS and the Cochrane Central Register of Controlled Trials and reference lists of existing systematic reviews were searched until August 2017 to identify relevant studies. Study search and selection were performed by two independent reviewers. 4791 articles were retrieved of which 11 RCTs (n=3772) were included. A meta-analysis with random effects model was applied to estimate the pooled results.

Results: Telehealth was associated with a statistically significant and clinically relevant absolute decline in glycosylated haemoglobin (HbA1c) compared to usual care (mean difference -0.17%; 95% CI -0.25 to -0.09%; p<0.0001), especially if participants had a mean baseline HbA1c≥8.0%; were less than sixty years of age or received telehealth for less than one year.  There was no clinically significant reduction in LDL-cholesterol (LDL-c), body mass index (BMI), systolic (SBP) or diastolic blood pressure (DBP). 

Conclusion: Telehealth interventions were associated with improved glycaemic control (HbA1c) in T2DM diabetic patients. However, no clinically relevant impact was observed on lipid profile, blood pressure, body mass index and psychosocial well-being. Future studies should seek to evaluate the effect of intervention duration on HbA1c, psychosocial outcomes and the effectiveness of telehealth in rural and underserved populations.  

Biography:

Anongnad Mee-inta, physical therapy lecturer, has the experience of evaluation and treatment in physical therapy.  She has teaching, research, evaluation, and treatment in the cardiopulmonary physical therapy management.  Both clinical and research that she is interested involved with noncommunicable disease especially in diabetes mellitus. This research is based on the data from patients of Somdet Prayannasungworn Hospital, Thailand. This result of this study might be advantage for the policy of pulmonary complication prevention in patients with diabetes mellitus in Thailand.

Abstract:

Diabetes mellitus (DM) is a chronic disease which frequently found in the world population.  The complications of diabetes mellitus can lead to other comorbidities and mortalities.  In addition, pathology of diabetes can cause microangiopathy in alveoli which have contributed to restrict lung volume, capacity, and change in pulmonary functions. However, little is known about the mechanisms of lung dysfunction and there is controversial about relation among duration of diabetes, HbA1c, and pulmonary function in patients with type 2 diabetes mellitus.  Thus, the present study was aimed to evaluate the correlation among duration of diabetes, HbA1c, and pulmonary function in patients with type 2 diabetes mellitus.  A cross-sectional study was conducted at Somdet Prayannasungworn Hospital, Chiang Rai, Thailand.  Forty participants had diagnosed of type 2 diabetes mellitus from physician, both men and women, and aged between 40-70 years old.  All participants were interviewed for demographic data and duration of diabetes.  They also were tested HbA1c and pulmonary function tests (PFTs) from trained physical therapist.  Forced expiratory volume in one second (FEV₁), forced vital capacity (FVC) and ratio of FEV₁ and FVC (FEV₁/FVC), and forced expiratory flow at 25-75% (FEF 25-75%) were measured by spirometry.  The results showed that diabetes duration was statistical significantly negative correlated with forced expiratory volume in one second (FEV₁) (r= - 0.323, p-value< 0.05) and forced vital capacity (FVC) (r= - 0.349, p-value<0.05) while HbA1c was not correlated with pulmonary function.  Diabetes duration was significant associated with pulmonary function reduction in patients with diabetes mellitus.  The relationship among HbA1c and pulmonary function in patients with type 2 diabetes mellitus were not found in this study.

Biography:

Joseph Asante Obeng is a medical laboratory scientist by profession and academic qualification. In his quest to promote healthy living among the people in his community, his passion in this profession is geared towards endocrinology; diabetes and its management to be specific. Under my supervision, he has successfully conducted researches in this direction of his profession. This abstract been one of his recent works was inspired by the desire to use readily available materials to manage diabetes through careful scientific investigations and evaluations. This approach he believes if properly handled will go a long way to curb the menace of diabetes in his community.

Abstract:

Problem statement: Prevalence of type 2 diabetes (T2D) among the Ghanaian adult population is increasing. Interestingly, rural inhabitants tend to have lower prevalence and severity of T2D as compared to urban dwellers even though they (rural inhabitants) do not have access to proper medical services. The fall in prevalence and severity of T2D among the rural inhabitants is attributed to the use of unripe plantain peels (UPP) for T2D management. It is a routine practice by rural inhabitants to boil UPP, decant the boiled water and drink it when cooled. The purpose of this study is to investigate the chemical constituents of UPP and their medicinal effect on the management of T2D. Methodology: A qualitative case study was utilized on rural inhabitants who were known diabetes who volunteered to participate in the research. A digital glucometer was used for the estimation of glucose of participants before, during and after consumption of UPP decant and a standard scientific techniques were utilised to investigate the chemical constituents of UPP. Findings: The UPP decant upon investigation contained considerable amount of nutrients such as: Ca, K, Na, P and metals such as: Mg, Zn, Cu and Pb. Zinc found in higher concentration plays a vital role in the regulation of insulin production by the islets of Langerhans and glucose utilization by adipocytes and muscles. Magnesium another constituent found in higher concentration is a cofactor of hexokinase and pyruvate kinase and it also alters glucose transport across cell membranes. Conclusion: The research studies accentuate the medicinal potentials of UPP in the management of T2D. However, it is predictive that, prolong consumption of UPP decant may pose grave health problems in the long term since UPP contains considerable concentrations of lead (Pb) and cupper (Cu). Recommendation: More studies are encouraged to aid in the conversion of UPP into more useful and safe medicinal products.

Biography:

Dr. Komal Verma, Associate Professor, Amity Institute of Behavioral and Allied Sciences, Amity University Rajasthan

Abstract:

Diabetes mellitus  is one of the  most prevalent health problem which India is facing and self management is key component in dealing with it. Self management is considered to be individuals competency in handling situations but it is perceived to be more effective if influenced by social support. This study aims to assess the use and benefits of social media among patients with type 2 Diabetes in India as a well-being mechanism. Factorial design was used to address the study objectives. The current study reflects positive impact of usage of social media in managing type 2 diabetes, which also proves the theoretical base of social support and biopsychosocial model in managing long term illness. The results of the study adds to the current literature gap on perceived benefits of  social media use in managing diabetes and it can also help health care providers to understand the role of  social support which patients are considering to be important stakeholder in dealing with diabetes.

Biography:

Randhir Singh holds M.Pharm., Ph.D. degrees in Pharmacology. Presently, he is working as Professor in Department of Pharmacology in M. M College of Pharmacy, M.M. University, Mullana, Ambala, India. He has an experience of more than 13 years in teaching and research.  He has published more than 80 research and review articles in peer reviewed International Journals and his work is cited in highly reputed journals. He is an editorial board member of several journals. He has guided 09 Ph.D students (04 Awarded, 03 Submitted and 02 pursuing) and 08 M. Pharmacy students. He has received 02 projects worth 50 lacs from Goverment agencies of India.  He has received Prof Saroj V.N Sharma award for best paper published in cardiovascular sciences in India in 2011 and Best Faculty Award, form Association of Pharmacy Professional in January 2018. He has authored 04 books (02 National and 02 International) with reputed publishers. His area of research is diabetes and diabetic complications, obesity and hypertension.

Abstract:

Etiology of diabetic nephropathy is multifactorial with many pathogenetic mechanisms. Many plant products are being used traditionally in the management of diabetes and its complications. Our study was aimed to evaluate the potential of  hydro-alcohol extract (DHA) of Dillenia indica L. (Family: Dilleniaceae) in treatment of diabetic nephropathy by targeting renal  markers and  oxidative stress. DHA was evaluated for its inhibitory activity against formation of AGEs by using bovine serum albumin, sorbitol accumulation in human blood and aldose reductase in rat kidney. Diabetic nephropathy was assessed by determining serum glucose, insulin, renal parameters (urea, uric acid, creatinine level) and tissue histological examination. Tissue antioxidant enzymes (SOD, CAT and GSH) and LPO levels were measured along with the formation of AGEs in kidney to assess the effect of DHA in ameliorating oxidative stress. DHA showed significant inhibition against sorbitol accumulation and aldose reductase activity. DHA also produced significant attenuation in the glycemic status, renal parameter, lipid profile and level of antioxidant enzymes proving efficacy in diabetic nephropathy. Moreover, DHA has also produced significant reduction in the formation of AGEs in vitro as well as in kidneys. The results obtained from the study indicate the significant potential of D. indica as a possible therapeutic agent against diabetic nephropathy

Biography:

Reza Daryabeygi-Khotbehsara, a master of nutrition graduate from Tehran University of Medical Sciences. He has been an international chemistry teacher for a year and medical advisor (pharmaceutical) for 7 months. He is working as an marketing advisor & education specialist (at a pharmaceutical company) guiding medical and sales representative team. Reza has been involved in intervention studies as well as systematic reviews and meta-analyses mainly among people with diabetes.

Abstract:

Introduction: Global prevalence of diabetes in alarmingly high. Moreover, global economic burden of diabetes is striking. With respect to these, more cost-effective approaches are required.

Nigella sativa (N. sativa), a popular herb in Asia, is reviewed as a miraculous top rank herbal medicine, and widely used in folk medicine. However, any study has assessed the pooled effect of N. sativa on glycemia and serum lipids in diabetes. The present meta-analysis investigates the effectiveness of N. sativa in type 2 diabetes (T2D).

Methods: Literature search was conducted covering PubMed/Medline, Scopus, and Cochrane Registry of Clinical Trials up to February 2017 to obtain the relevant published intervention studies. Two researchers (R.D and M.G) were involved in the identification of eligible studies. Heterogeneity was assessed using I-squared (I2) statistics test. Subgroup analysis was done to assess type of N.sativa supplement as source of heterogeneity. Effect sizes of eligible studies were pooled using STATA software version 12 (STATA corp, College Station, TX, USA).

Results: Seven trials were included in the meta-analysis of glycemic and serum lipid profile end points. Supplementation with N.sativa significantly improved fasting blood sugar (FBS), HbA1c, total-cholesterol (TC) and LDL-cholesterol (LDL-c). The overall effects for triglyceride (TG) and HDL-cholesterol (HDL-c) were insignificant. Subgroup analysis revealed significant reduction on TG with N.sativa seed oil, while TG was increased with seed powder. All measures, but HbA1c, showed no evidence of publication bias.

Discussion: To the best of our knowledge, this is the first meta-analysis investigating the effectiveness of N.sativa in T2D. Promising benefits of N.sativa on glycemia (FBS and HbA1c) and lipid parameters (TC and LDL-c) provides robust evidence for the incorporation of N.sativa as an adjunct therapy in diabetes.

Biography:

Mohamed Farghaly is a Professor at Dubai Medical College, Senior Specialist at Dubai Health Authority, Member of UAE Technical Committee for Diabetes, Member of UAE National Diabetes Guideline Committee, Member of DHA Diabetic Board; Accredited Trainer in Family Medicine by the Royal College of General Practitioners in United Kingdom and Accredited Examiner for MRCGP (INT) and also the Chairman of Family Medicine Scientific Committee EMA.

Abstract:

Objective: The objective of the study is to understand the treatment patterns among newly diagnosed T2DM patients in Dubai and make broad-level comparisons against the ADA’s recommendations.

Method: A retrospective database analysis was conducted using Dubai claims database. All patients with a T2DM diagnosis were identified during July 2014 to March 2016 and their first diagnosis was assigned as the index diagnosis. Patients with a diabetes diagnosis or use of Anti-Diabetic Therapy (ADT) during prior six months were excluded. Patients were continuously enrolled during 6 months before and 12 months after the index diagnosis.

Result: The final study cohort included 25,320 patients, of which 63.1% did not receive any ADT during 12 months follow-up from the index diagnosis. For the remaining 9,349 patients, 54.6% patients received the first ADT on index diagnosis date, while the mean time to ADT for the remaining 45.4% patients was 68.6 days. The most common first ADT was metformin received by 88.9% patients, of which 42.9% received it as a monotherapy while remaining 57.1% received it in combination with another drug. The proportion of patients having their first ADT as combination therapy or insulin was 50.3% and 4.3%, respectively. Mean number of oral prescriptions during follow-up was 2.9. The average most recent HbA1c value before initiating monotherapy, combination therapy and insulin-based therapy was 7.0, 8.4 and 9.1, respectively.

Biography:

The author received an honorable PhD in mathematics and majored in engineering at MIT. He attended different universities over 17 years and studied seven academic disciplines. He has spent 20,000 hours in T2D research. First, he studied six metabolic diseases and food nutrition during 2010-2013, then conducted research during 2014-2018. His approach is “math-physics and quantitative medicine” based on mathematics, physics, engineering modeling, signal processing, computer science, big data analytics, statistics, machine learning, and AI. His main focus is on preventive medicine using prediction tools. He believes that the better the prediction, the more control you have.

Abstract:

Based on his research, the author developed two prediction tools and was able to reduce his PPG from 380 mg/dL to 116 mg/dL, daily glucose from 279 mg/dL to 117 mg/dL, and A1C from 10% to 6.1%

He examined correlations between PPG and three known major factors, medication, carbs and sugar intake, exercise, and other secondary factors, including stress/tension, measurement time delay, traveling, illness, sleep disturbance, seasonal weather, etc. In summary, more than 20 elements were considered and over 1 million data collected.

During 934 days (from 6/1/2015 to 12/21/2017), he had 2,802 meals and collected about 60,000 PPG-related data. The conclusions were: +60% correlation between PPG and carbs and sugar intake (average 14.7 gram and 38% contribution rate); - 64% correlation between PPG and post-meal walking (average 4,300 steps and 43% contribution rate). Collectively, these secondary factors account for approximately 19% (weather has contributed 10%) of the predicted PPG values.

Those collected 2,800 meal photos were analyzed against 6 million food data collected and re-processed from US government and stored in cloud server.  All food data were sorted according to country, franchise restaurants, individual cafes,

home-cooked meals, airline food, etc. Here are some examples:

Airline food - 136 mg/dL; Restaurant food - 127 mg/dL; Home

Cooking - 111 mg/dL.

The predicted PPG (115.5 mg/dL) vs measured PPG (120.5

mg/dL) has a linear accuracy rate of 96% and 87% correlation.

Biography:

Gerald C Hsu has received his PhD in Mathematics and majored in Engineering at MIT. He has attended different universities over 17 years and studied seven academic disciplines. He has spent a huge time research in T2D research. His approach is “Math-Physics and Quantitative Medicine” based on mathematics, physics, engineering modeling, signal processing, computer science, big data analytics, statistics, machine learning and AI. His research focus is on preventive medicine using prediction tools.

Abstract:

The author developed two prediction tools and was able to reduce his PPG from 380 mg/dL to 116 mg/dL, daily glucose from 279 mg/dL to 117 mg/dL, and A1C from 10% to 6.1%. The author examined correlations between PPG and three known major factors, medication, carbs and sugar intake, exercise and other secondary factors, including stress/tension, measurement time delay, traveling, illness, sleep disturbance, seasonal weather, etc. In summary, more than 20 elements were considered and over 1 million data collected. During 934 days (from 6/1/2015 to 12/21/2017), he had 2,802 meals and collected about 60,000 PPG-related data. The conclusions were: +60% correlation between PPG and carbs and sugar intake (average 14.7 gram and 38% contribution rate); 64% correlation between PPG and post-meal walking (average 4,300 steps and 43% contribution rate). Collectively, these secondary factors account for approximately 19% (weather has contributed 10%) of the predicted PPG values. Those collected 2,800 meal photos were analyzed against 6 million food data collected and re-processed from US government and stored in cloud server. All food data were sorted according to country, franchise restaurants, individual cafes, home-cooked meals, airline food, etc. Here are some examples: Airline food - 136 mg/dL; Restaurant food - 127 mg/dL; Home Cooking - 111 mg/dL. The predicted PPG (115.5 mg/dL) vs. measured PPG (120.5 mg/dL) has a linear accuracy rate of 96% and 87% correlation.

Biography:

Randhir Singh is currently working as a Professor in Department of Pharmacology in M M College of Pharmacy, Maharishi Markandeshwar University, Mullana, Ambala, India. He has an experience of more than 13 years in teaching and research. He has published more than 80 research and review articles in peer reviewed international journals and his work is cited in highly reputed journals. He is an Editorial Board Member of several journals. He has received two projects worth 50 lakhs from Government agencies of India. He has received Prof. Saroj V N Sharma Award for Best Paper published in Cardiovascular Sciences in India in 2011 and Best Faculty Award from Association of Pharmacy Professional in January 2018. He has authored four books (two national and two international) with reputed publishers. His area of research is diabetes and diabetic complications, obesity and hypertension.

Abstract:

Etiology of diabetic nephropathy is multifactorial with many pathogenetic mechanisms. Many plant products are being used traditionally in the management of diabetes and its complications. Our study was aimed to evaluate the potential of hydro-alcohol extract (DHA) of Dillenia indica L. (Family: Dilleniaceae) in treatment of diabetic nephropathy by targeting renal markers and oxidative stress. DHA was evaluated for its inhibitory activity against formation of AGEs by using bovine serum albumin, sorbitol accumulation in human blood and aldose reductase in rat kidney. Diabetic nephropathy was assessed by determining serum glucose, insulin, renal parameters (urea, uric acid, creatinine level) and tissue histological examination. Tissue antioxidant enzymes (SOD, CAT and GSH) and LPO levels were measured along with the formation of AGEs in kidney to assess the effect of DHA in ameliorating oxidative stress. DHA showed significant inhibition against sorbitol accumulation and aldose reductase activity. DHA also produced significant attenuation in the glycemic status, renal parameter, lipid profile and level of antioxidant enzymes proving efficacy in diabetic nephropathy. Moreover, DHA has also produced significant reduction in the formation of AGEs in vitro as well as in kidneys. The results obtained from the study indicate the significant potential of Dillenia indica as a possible therapeutic agent against diabetic nephropathy.

Biography:

Dr. Mohammad Saifuddin, young eminent endocrinologist of Bangladesh who dedicated himself in service of humanity towards rural people of Bangladesh. He passed MBBS from Dhaka Medical College at 2004 and obtained fellowship in Medicine (FCPS) from Bangladesh College of Physicians and Surgeons at 2012 and passed MD (Endocrinology) from BIRDEM Academy at 2013. He is working in Bangladesh Civil Service for last 10 years and now working as Assistant Professor (Endocrinology) in Abdul Malek Ukil Medical College, Noakhali, Bangladesh. He has 14 publications in national and international level. His work of interest in Diabetes and complications, Adrenal disorders, Osteoporosis, Thyroid disorders, Menstrual abnormalities.

Abstract:

Patients with diabetes mellitus (DM) are prone to develop infection, especially urinary tract infection (UTI) in comparison with non-diabetics. Due to the emergence of multidrug resistant (MDR) uropathogenic strains, the choice of antimicrobial agent is sometimes difficult. This study is designed to reveal the distribution of uropathogens in Diabetic patients and corresponding sensitivity patterns and to correlate the microbiological results with various clinical parameters. A nine month retrospective review of 100 urine culture reports of Diabetic patients from January 2015 to September 2015 from  semiurban multispeciality hospital of  Feni, Bangladesh were analyzed. Only Diabetic patients were included in this study who were clinically diagnosed as UTI patients with a corresponding urine culture showing a bacterial count of ˃10⁵cfu/ml. Out of 100 patients with UTI, 39 (39%) were male and 61 (61%) were female. Organisms grown in urine culture were Escherichia coli (64) followed by Klebsiella (11), Proteus (7), Staph Aureus (4), Pseudomonas (4), Acinetobacter (3), Sreptococcus (3), Enterococcus (2) and one each of Enterobacter and Fungi. Overall sensitivity pattern in decreasing order of various commonly used antibiotics were Meropenem (89%), Nitrofurantoin (86%), Amikacin (81%), Ceftriaxone (68%), Cefuroxime (61%), Cefixime (39%), Quinolones (28%), Amoxicillin (16%). The significance of the study lies in the determination of common pathogens in diabetic patients with UTI and the resistance pattern of antibiotics so that physicians and pharmacists get the proper information rationalizing the rational use of antibiotics.

Biography:

Emilio Galea started his career in healthcare in 1985 in Malta where he held different positions, from direct care, clinical instructor and examiner with the Institute of Healthcare and managerial positions. He went to the Middle East in 2007 as a Clinical Resource Nurse and then Assistant Director of Nursing. His role included the function of wound management advisor. Emilio is active in conferences and was awarded with the Speaker of the Year Award by the Health Authority of Abu Dhabi. He contributes regularly to magazines and wound care journals and also published the ‘Wound Care Product Catalogue’ that provided guidelines regarding advanced wound care products in SEHA facilities. Emilio is currently the International Medical Director for Urgo International. He holds an MSc Skin Integrity Skills & Treatment from the University of Hertfordshire (UK) and his personal and professional objective is to facilitate, through education, evidence based wound management practice.

Abstract:

A growing proportion of diabetic foot ulcers are being diagnosed as neuro-ischemic. Diabetic foot ulcers (DFUs) score high in the incidence of chronic wounds; the annual population-based incidence of DFUs ranges from 1.0% to 4.1%, with a lifetime incidence that may be as high as 25% globally. Neuro-ischemia predominately leads to the development of ulcers on the margins of the foot, toes and dorsum of the foot rather than at pressure sites from poorly fitting shoes. Management of this type of wound is complex, requiring prompt referral, debridement where indicated, appropriate footwear, offloading, dressings and the treatment of infection. Although neuro-ischemic ulcers are the most common DFUs, until recently, no studies have assessed the superiority of any device in a cohort of patients with only neuro-ischemic ulcers and no device or drug has demonstrated efficacy in neuro-ischemic DFU treatment.

The discovery that matrix metalloproteinases and neovascularization are involved has led to the identification and study of nano-oligosaccharide factor (KSOS molecule), which shows promise in treating this challenging condition. Conducted on 240 patients across five European countries, the Explorer study represents a clinical research first in the field of diabetic foot ulcers. The randomized, double-blind study compares the efficacy and tolerance of the TLC-NOSF matrix to those of a neutral dressing on neuro-ischemic diabetic foot ulcers. Reactions to the Explorer RCT have been very promising, where it was suggested that: “the results are certainly more encouraging than findings for most interventions that have been reported to date”

An overview will be provided regarding the global burden of diabetic neuro-ischemic ulcers and the results of the ground breaking double blind study published in The Lancet, that has identified effective local treatment of these devastating ulcers. 

Biography:

Dr. Andleeb Batool has expertise in Molecular Biology and human genetics. Currently working on Epidemiology familial genetics of Type 1 and Type 2 Diabetes.

Abstract:

Type 2 diabetes (T2D) has been the subject of numerous genetic studies in recent years which revealed associations of the disease with many susceptibility loci. We evaluated the 10 genes (TCF7L2, HHEX, ITGA2, CDKL1, ADRB3, PRKCB1, CETP, GNB3, LTA, LPL, PPARG) for susceptibility of T2D in Pakistani population by performing a case-control study. A total of 450 subjects (Patients= 280, Controls = 70) participated in the study. Genotyping was performed by PCR-RFLP and overall, 6 SNPs from the study were found to be significantly associated with T2D. ITGA2 (rs1062535- rs1139484- KT359366) was first time studied in south Asians which showed a significant association with T2D and a novel SNP was identified and got its accession number (KT359366). The loci from HHEX, ITGA2, LTA, PPARG and ADD1 remain associated with T2D after SNP and genotype analysis (P < 0.05) while GNB3 and PRKCB1 were only associated in genotype analysis. Two haplotypes (GAT, GGC) from ITGA2 were associated with T2D development while GGT (p-0.0001) was protective against diabetes. No association was detected with TCF7L2, CDKL1, ADRB3, CETP, GNB3, and LPL. This data can be used for prevention and screening of population at risk, moreover can be helpful in large scale studies.