Day 1 :
Keynote: Role of maternal lipids on neonatal body weight under healthy and gestational diabetic conditions
Time : 09:00 to 09:30
Emilio Herrera is PhD from Complutense University (Madrid), Emeritus professor of Biochemistry and Molecular Biology at Faculties of Pharmacy and Medicine, University San Pablo-CEU in Madrid, Spain and Doctor Honoris causa in Medicine by Lund University (Sweden). He carried out his postdoctoral studies in Harvard University and Northwestern University Medical Schools. He has 282 peer-reviewed papers with IF (total IF by JCR-2009, 755.20) and 77 book chapters, having a h-index of 37 and has directed 49 PhD thesis.
During early pregnancy, the increase in maternal fat depots is facilitated by insulin, followed by increased adipose tissue breakdown and subsequent hypertriglyceridemia, mainly as a result of insulin resistance (IR) and estrogen effects. Most fatty acids (FAs) in maternal circulation are esterified and associated with lipoproteins which are taken up by the placenta and hydrolyzed by lipases and the released FAs enter fetal circulation. Under control conditions maternal glucose but not triacylglycerides (TAG) or nonesterified fatty acids (NEFA) correlate with neonatal weight, BMI or fat mass. However in gestational diabetic mellitus (GDM) the fetus does not seem to receive more FAs than in non-GDM pregnancies but whereas maternal glucose doesn’t correlate with fetal anthropometric parameters TAG and NEFA show significant correlations. In newborns of GDM mother’s serum glucose and consequent insulin levels are high and such hyperinsulinemia would facilitate TAG synthesis, contributing to their increased adipose tissue mass. Long-chain polyunsaturated FAs (PUFA) are essential for fetal development and are obtained from the mother. The proportion of arachidonic, docosahexaenoic and total n-6 and n-3 PUFA are lower in umbilical arterial plasma but not in venous plasma of neonates of GDM vs. controls indicating an altered metabolism of PUFA by the fetus of GDM mothers. In rats a moderate increase in dietary n-3 PUFA during early pregnancy reduces adiposity and the age-dependent insulin resistance in 12 months old male offspring. The increase in body fat in neonates of GDM women is a risk factor for obesity in early childhood and later life.
University of Pretoria
Keynote: Can viscoelastic and ultramicroscopy techniques be a potential tool in a precision medicine approach for type II diabetes patients?
Time : 10:30-11:00
Etheresia Pretorius of the Department of Physiology, Faculty of Health Sciences, University of Pretoria is one of the Africa’s top women scientists, and she was the recipient of the African Union Kwame Nkrumah Scientific Awards Programme (Basic Science and Technology: African Women in Science), in 2011. Since 2000, she published/in press over 200 ISI rated research manuscripts. Her research has brought new insights into inflammation pathology and she has identified new methods that may be used in tracking disease progression. The majority of the afore-mentioned research has been published in high impact journals, including The Lancet (IF: 45.102) and FEMS (IF: 13.8).
Type II diabetes causes an ever-increasing burden on healthcare. The prevalence for all age-groups worldwide was estimated to be 2.8% in 2000 and predicted to increase to 4.4% in 2030. Among adults in the US, the prevalence of undiagnosed diabetes is currently 4.1% and pre-diabetes a staggering 35.6%. Type II diabetes is associated with three main glycemic disorders that are chronic hyperglycemia, glycemic variability, and iatrogenic hypoglycemia and also comorbidities including dyslipidemia and hypertension. All of the above comorbidities are associated with hypercoagulability. Because type II diabetes is such an extensive health issue, we suggest that the answer to adequate treatment is based on an individualized patient-centered approach, in combination with the latest NIH precision medicine approach. A combination of viscoelastic methodologies may be used in a personalized patient-centered regime, including thromboelastography (TEG) and the lesser, used scanning electron microscopy approach (SEM). TEG is a dynamic measure of clot formation, strength and lyses, while SEM provides a visual structural tool to study patient fibrin structure in great detail. We therefore consider the evidence for TEG and SEM as a unique means to monitor type II diabetes treatment efficacy. TEG and SEM has potential to be a useful tool combination, and could potentially alter clinical approach to type II diabetes treatment. As envisaged in the NIH precision medicine approach, it will involve a lot of role players and innovative new research ideas; with this ultimate goal in mind, we suggest that an individualized patient-orientated approach is now already within our ability.