12^th European Diabetes Congress September 15-17, 2016 Berlin, Germany

Biography:

Qiang Tu is currently enrolled as a full-time PhD student at Flinders University, Australia. This paper reports part of his PhD project entitled: “A nurse-coordinated hypertension management program for community-dwelling older people with diabetes in Nanchang, China: A cluster randomized controlled trial”. He has been engaged in caring for patients with chronic conditions since his undergraduate medical study. He has published a number of research articles in Chinese Journal prior to his PhD study. His PhD study is supervised by Prof. Lily Xiao, Prof. Jeff Fuller, Dr Huiyun Du and Dr Shahid Ullah.

Abstract:

Background:  Hypertension is poorly controlled in older people with diabetes. China has a large number of older populations living with diabetes and hypertension, and yet an underdeveloped primary care system to manage the conditions effectively. Research evidence on hypertension management for this population is limited.

Aims: To gain health professionals’ consensus on the applicability of an evidence-based hypertension management program.

Methods: A comprehensive literature review was undertaken to develop an evidence-based hypertension management program for community-dwelling older people with diabetes. The program were stated in a questionnaire and distributed to health professionals in Nanchang who were specialized in the area of practice via Email. This Delphi study set out 75% and over agreement as the consensus rate.

Results: Main interventions in the questionnaire include health education, lifestyle modification, medication adherence and intensification and follow-up visit. These interventions are built on the collaboration of health professionals between hospitals and community health services centers (CHSCs). Seventy participants completed the study. Participants were doctors, nurses, pharmacists and dieticians and from hospitals and CHSCs. Of the 28 intervention statements, 22 achieved consensus in round one and the other 6 were modified with consensus achieved in round two. Modification of the interventions was based on participants’ comments and addressed how to share the planned interventions by health professionals based on their availability, accessibility and roles in the healthcare system.

Conclusion: An evidence-based hypertension management program for community-dwelling older people with diabetes built on cross-sector and inter-professional collaboration was viewed as applicable in Nanchang, China.

Biography:

Saba Noor is a PhD scholar, working under the supervision of Professor Jamal Ahmad at Rajiv Gandhi Centre for Diabetes and Endocrinology, Faculty of Medicine, J N Medical College. She has completed her Masters and graduation in Biochemistry from Department of Biochemistry, Faculty of Life Sciences from the same university. She has published one original article and one review in peer-reviewed reputed international journals and presently working to improvise the diagnostic tools implemented in exploring microbial spectrum and immunological studies among diabetic foot patients. 

Abstract:

Diabetic foot ulcerations (DFUs), a dreadful micro-vascular complication is responsible for substantial increase in morbidity and mortality. DFU is a complicated amalgam of, neuropathy, peripheral arterial diseases, foot deformities and infection. Spanning the spectrum from superficial cellulitis, microbial flora leads to chronic ostemyelitis and gangrenous extremity requiring surgical interventions and lower limb amputations. Though expeditious and precise discerning of bacterial pathogens is a fundamental grail, of clinical diagnostic microbiology but when conventional methodologies are implemented in identifying bacteria, interpretation of test results requires substantial slanted judgment. Therefore, genotypic detection is budding as substitute to known phenotypic culture based processes. Typically, genotypic identification of bacteria involves the use of conserved sequences within phylogenetically informative genetic targets. Also time required in conventional diagnosis delays the selection of antibiotic regime making and adversely affects the outcome. Therefore, we report a comparative evaluation of biochemical and genomic based assays for exploring the common bacterial flora in infected DFU patients along with clinical variables of subjects enrolled. The pathogens selected (i) Kleibseilla pneumonia, ii) Pseudomonas aeruginosa, iii) Escherichia coli and iv) Staphylococcus aureus , stood for the most frequent isolates of diabetic foot infection (DFIs) in previous studies from Northern India. Of 50 specimens obtained from infected DFUs, 74% of cases were affirmative by bacteriological assays and 95% showed positivity via PCR methodologies. Among processed samples 44 isolates were detectable through phenotypic analysis and 73 bacteria by species specific PCR. 13 samples and 19 isolates could not be scrutinized by phenotypic identification systems. The most prevalent pathogens identifiable by both assays were Klebseilla pneumonia, followed by Staphylococcus aureus, Pseudomonas aeruoginosa and Escherichia coli. We have shown that PCR based diagnostic methods improved the identification of common aerobic pathogens compared to conventional phenotypic methods. The outcome of this study expresses that polymerase chain reaction provides rapid, unambiguous identification of clinical bacterial isolates. The results highlight the incorporation of PCR technique in bacterial identification due to shorten turnaround time and may translate into improve clinical outcomes by early use of appropriate antibiotic along with other principles followed in diabetic foot management.

Biography:

Soha N Yazbek is an Assistant Professor of Genetics at the Medical Laboratory Sciences Program, AUB. She is trained in Basic Genetics and focuses on researching the genetic basis of complex multifactorial diseases (diabetes and non-communicable diseases). She also works to identify the research gap in non-communicable diseases in selected countries of the region. Recently, her research has focused on the genetic disease status and the genetic service response in Lebanon. She holds a PhD in Genetics from Case Western Reserve University, and MS in Molecular Biology from the Lebanese American University and a BS in Medical Laboratory Sciences at AUB.

Abstract:

Type II diabetes is one of the most common endocrine disorders. The cumulative action of genetic variants account for 10% of heritability. SLC35b4, a solute receptor associated with obesity, insulin resistance and gluconeogenesis, transports UDP-N-acetylglucosamine and UDP-Xylose. The correlation between expression and functionality and the mechanism of action have not been elucidated. This study aimed to investigate the regulation of protein expression and localization of SLC35b4. We also aimed at comparing differentially expressed proteins between a knockdown of SLC35b4 and controls in HepG2 cells in order to decode its implication in macromolecules glycosylation and sugar production. Responsiveness was assayed using western blot analysis and immunostaining. To identify the cytoplasmic compartment harboring SLC35b4, double immunofluorescence (SLC35b4-Golgi apparatus and endoplasmic reticulum) studies were performed. The subcellular localization was confirmed using a PLA technique (duo-link). 2D gel elctrophoresis and MALDI_TOF were used to identify differentialy expressed protiens. Pathway analysis was performed to understand the downstream effect of the gene knock-out. Results revealed SLC35b4 is increased up to 60% upon glucose stimulation. SLC35b4 localized with Golgi apparatus and to a lesser extent with the endoplasmic reticulum. The presence of SLC35b4 in the Golgi apparatus confirms its involvement in the biosynthesis of glycoconjugates proteins. Four proteins were under-expressed when SLC35b4 gene was knocked out (HSPD, HSPA8, TUBA1A, and ENO1), all of which are involved in pathways affecting glucose and insulin homeostasis.We suggest that SLC35b4 activation alters the glycosylation pattern inside the cells causing an improvement of the insulin ability to inhibit endogenous glucose production.

Biography:

Joseph Shemesh is a full clinical Professor of cardiology at the Sackler School of medicine, Tel-Aviv University, Israel. He is a recognized investigator in the field of non-invasive detection of sub-clinical coronary atherosclerosis. As one of the pioneers in this field, he used in 1995 the Twin dual slice CT device which was the prototype of all the multi-slice CT devices and led the first publication that demonstrated the validity of coronary artery calcifications (CAC) measuring by mechanical CT. During the last 20 years he published over 50 original articles that contribute to the understanding of the clinical significance of CAC and its application to the daily clinical practice. In his recent publications he demonstrated the incremental prognostic value of CAC measuring in high risk populations including smokers, diabetics and hypertensive patients.

Abstract:

Coronary artery calcification (CAC) is the best surrogate marker of the total burden of coronary atherosclerosis. Its presence in asymptomatic subjects indicates sub-clinical disease and its quantity reflects the extent and the chronicity of the disease. CAC can be easily measured and reported by radiologists while reading chest CT. The presence or absence of CAC contributes to the reclassification of diabetic patients, pre-diabetics and those with metabolic syndrome as well. Prospective studies demonstrated that approximately one third of asymptomatic, middle aged, diabetic patients have no CAC detected indicating an excellent prognosis. In a meta-analysis of 8 studies that includes 6521 diabetics with a follow-up of 5.8 years, the presence of CAC is associates with a relative risk of 5.47 for all cause mortality or CV events and 9.22 for fatal and non fatal CV events. The recently published MESA CHD risk score is the first available algorithm incorporating CAC with traditional risk factors for 10-year risk prediction. For example in a 60 years old diabetic Caucasian male without CAC, the estimated 10-year MESA score risk of CHD event including the CAC score=0 is reduced to 3.5% compared to 9.3% if one did not factor in his CAC score. In summary, CAC reflects the atherosclerosis sequelae of the individual long-life global exposure to all the risk and protecting factors. It contributes to reclassify risk in diabetic patients and may improve individualized treatment.

Biography:

Mualla Yilmaz completed her PhD in Psychiatric Nursing at Marmara University Institute of Health Sciences in 2007. She started working as an Assistant Professor at Mersin University School of Health in 2009 and became an Associate Professor in 2014. She holds the post of head of the department of Psychiatric Nursing and deputy director of Mersin University School of Health and she has published many articles in international and national journals. Her main area of research is Consultation-Liaison Psychiatry Nursing. She is currently conducting studies on psychosocial problems of chronic diseases (e.g. diabetes, kidney failure, heart failure). 

Abstract:

Background: Diabetes mellitus (DM) is a complex and chronic disease with multiple complications leading to increased mortality and poor quality of life. How the disease is perceived by the individual, the meaning of the disease, illness and treatment compliance, and psychosocial difficulties are some of the issues that need to be addressed. Mental, emotional, social and psychosexual problems and conflicts arise because this is a lifelong disease and requires a continuous controlled lifestyle.

Aim: The aim of this study was to determine what it means for patients to live with diabetes, to reveal patients’ feelings, thoughts and wishes, and to examine their perspectives and coping strategies regarding the disease.

Method: The study population consisted of all the patients treated for Type II DM at the Department of Endocrinology at a University Hospital (N=350). The sample consisted of 37 patients meeting the inclusion criteria in the study. Data were collected by asking the participants a total of three questions in the individual in-depth interview form. After transcribing the recorded interviews, the transcripts were combined with observation notes and then raw data were transferred to computer. Finally, a content analysis was performed.

Results: Out of the patients in the study, 50% were female, 80% were married and the mean age was 57 years. Three main themes with 10 subthemes emerged from the content analysis: “Experiences during the Diagnosis Stage”, Experiences after Diabetes Diagnose”, and “Management of and Coping with Diabetes”. The results showed that diabetes adversely affected the participants’ lives; they experienced mental, physical and social problems related to the illness; and they exhibited a fatalistic approach feeling convinced that everything comes from God and feeling thankful in coping with these problems. Also, after being diagnosed with diabetes, more than half of the participants rearranged their lives by doing exercise, going for a walk, paying particular attention to nutrition and diet, visiting their doctors, and regularly checking their blood sugar.

Conclusion: In the management of diabetes, patients can adapt to the disease by expressing their emotions and thoughts and by realizing the meaning of life with the disease. Nurses have extremely important responsibilities in this process.

Biography:

Kyung Yul Hur, is Professor and chief of General Surgery at Soonchunhyang University hospital, Seoul, Korea. He graduate Soonchunhyang University, school of medicine at 1984.

And then god degree of master, doctor at the same university.  Now he is hepatobiliary and pancreatic surgeon among the various surgical field. He has lot of experiences with the liver and pancreas surgery such as major hepatectomy and pancreatico-duodenectomies and invented many innovative expedient technique for procedure.

He also has great interest in developing new technology and procedure. During his staying in the United States of America from 1999 to 2000, he focused and spent all of the time to the laparoscopic surgery. He stamped to the pioneer of laparoscopic surgical field in Korea. He adopted laparoscopic TEP hernia repair in Korea, and 1^st surgeon who performed gastric bypass to deal with metabolic issues. 

Abstract:

The most potent therapeutic modality for type 2 diabetes is rerouting of food passage or restriction of food intake by surgery. But, the Achilles heel of surgery is surgical risk itself.  So far, aggressiveness and morbidity were excusable in surgical treatment because it was final modality for most cases. But, in metabolic & bariatric surgery, it’s just the beginning of treatment. We need to carefully weigh the pros and cons before surgical intervention. Recently, we have found acceptable operative procedure for cure of diabetes. Before discussing about the mechanism of surgery, it would be better to open our published data for better understanding. The numbers of patients who have been followed up for more than 5 years were 60. Among them, 37 patients were analyzed. Outcomes of preoperative, post-operative 1st year and 4th year follow-up were included. The HbA₁C, HOMA-IR, Matsuda index and acute insulin response were analyzed to evaluate blood glucose control, insulin resistance, insulin sensitivity and pancreatic beta cell function. Perioperative incretin changes were evaluated in 12 non-obese subjects to compare at before the surgery and 1 month after by ELISA. Preoperatively, mean age was 48, BMI was 24.5 and HbA₁C level was 9.1%. 30 patients (81%) have shown decreased HbA₁C lower than 6.9% during the follow up. HbA₁C decreased continuously after the surgery. HOMA-IR decreased at first year after the surgery and then increased within the acceptable range.  Interestingly, insulin sensitivity, which is represented by Matsuda index, sharply increased at first year and then recovered. The major cause of type 2 diabetes in East Asia has been thought to be impaired insulin secretion rather than increased insulin resistance. Modulation of gastric emptying in response to signal from small intestine prevents dumping syndrome, marginal ulcer, diarrhea, bile reflux to stomach and so forth. But, care should be taken to pyloric preservation. Meticulous analysis of published data for duodeno-jejunal bypass, anti-diabetic effect of surgery is extremely inconstant between paper to paper. Subtle difference between two groups was whether preservation or exclusion of pyloric ring. In other word, completeness of duodenal mucosal exclusion is possible determinant. Incomplete exculsion of duodenal tissue is directly connected with recurrence of hyperglycemia. Unique pattern of mucosal regeneration is key element of recurrence. Intestinal mucosa is replaced with its progeny adjourn to another villi within 5 days. Anastomosed jejunal epithelium becoming duodenal epithelium will be a reasonable thesis. Best design of rerouting is preservation of pyloric digestive function simulaneously complete exclusion of duodenal mucosa. he pyloro-enteric anastomosis technique guarantees both anti-diabetic effect and functional preservation. Incretin secreting entero-endocrine cells never found in pyloric ring covered with gastric mucosa. Guarantee of anastomosis safety by 5cm epigasrtic incision with extracorporeal hand-sewing is another benefit. Result is more than better for 7 patients underwent single anastomosis pyloro-enterostomy. Long-term follow up for effectiveness and safety is mandatory.

Biography:

Love Onuorah is currently a PhD student at University of Hull, UK. She is researching on type-2 diabetes and ethnic minority groups. Upon completing her first degree in nursing, she worked with end stage renal patients as a dialysis nurse for some years where her interest in diabetes grow, before going to Anglia Ruskin University for her MSN.

Abstract:

Diabetes and its complications disproportionately affect ethnic minority groups. It is estimated to be the fifth leading cause of death in the U.K., with about 10% of the NHS annual budget used for its treatment. Despite the various educational programs to enhance self-management, the outcome remains poor. Adequate plans and policies informed by findings from assessing the views of the population at high risk is needed for desirable outcome. There is a gap in literature on the views and knowledge of diabetes for the high risk black Africans. Studies indicate that perceptions or knowledge about health and illnesses influence behaviors and attitudes towards health conditions like diabetes. Hence, programs for diabetes prevention and self-management should be based on findings from exploring individual or groups’ perceptions. This systematic review explores the views and knowledge about this disease and its impact on self-management among black Africans. Key data bases were systematically searched and the papers that met the strict inclusion criteria were selected. Primary empirical studies, written in English language, assessing perception (and its synonyms) and self-management in blacks, black Africans, African-Caribbean and African-Americans were included. Selected studies were assessed for Methodological quality using the McMaster framework, and the studies were extracted under relevant headings. Data were analyzed using thematic analysis to identify the different emergent themes. Findings on how black Africans perceive or understand type-2 diabetes and how that influences its management will be presented. 

Biography:

Haipeng Xiao, MD, PhD is the Professor of Endocrine, Chief Expert President, at the First Affiliated Hospital of Sun Yat-sen University. He is the Member of American Thyroid Association (ATA), member of Continuing Medical Education (CME) Committee, American Endocrine Society, member of Association for Medical Education in Europe (AMEE), and the Vice Secretary General, Clinical Teaching Committee of Medical Education, Ministry of Education, P. R. China. He is the Editorial Board Member of, Chinese Medical Journal, Chinese Journal of Endocrinology and Metabolism, Chinese Journal of Diabetes and Cardiovascular Endocrinology. As a long-term researcher in endocrine and metabolic diseases, he has published over 50 papers in core Chinese and foreign periodicals such as Journal of Clinical Endocrinology & Metabolism (JCEM), Brain Research, etc. Moreover, he took the lead in treating Graves’ diseases by introducing thyroid arterial embolization, and for the first time ever, he reported relevant findings of using innovative methods to treat Graves’ diseases in the prestigious Journal of JCEM. In June of 2012, he published another academic thesis “Circulating MicroRNA Profiles as Potential Biomarkers for Diagnosis of Papillary Thyroid Carcinoma” in JCEM which has received high attention and positive response among medical scientists home and abroad.

Abstract:

Diabetes is a chronic metabolic disease characterized with elevated glucose and lipid disturbance, which pathogenesis involves beta cell dysfunction and insulin resistance. Liraglutide is administered as GLP-1 receptor agonist on patient with diabetes mellitus and shows protective effect on beta cell function by inhibiting its apoptosis and promoting its proliferation and regeneration. MicroRNAs (miRNAs) are a category of endogenous non-coding small RNA, which inhibit the translation by binding to the 3’ untranslated region (3’ UTR) of their target mRNAs. It has become increasingly clear that miRNAs are not only involved in regulation of cell differentiation and apoptosis, but also in the pathogenesis of a variety of diseases. In our study, we aim to investigate the miRNA level differentially expressed in the pancreatic tissues of normal or diabetic SD rats without or with administration of Liraglutide, screen intended miRNA and predict its target gene，and explore the mechanism by which miRNA contributes to the anti-apoptotic effect of Liraglutide on pancreatic beta cells. We revealed differential expression of miRNAs and validated the increased expression of miR-139-5p in diabetic rats, while which decreased in diabetic rats with administration of liraglutide. We verified the direct regulatory effect of miR-139-5p on insulin receptor substrate 1(Irs1), a key player in insulin signal transduction pathway, through the target sequence ACTGTAG by using double luciferase report experiments. We also found palmitic acid can increase the expression of miR-139-5p and reduce IRS1 expression at both mRNA level and protein level in INS1 cells. Furthermore, administration of Liraglutide decreased the expression of miR-139-5p and enhanced the expression of IRS1, which protected both pancreatic tissues of SD rats and INS1 cells from apoptosis. Our data demonstrates that increased expression of miR-139-5p, which targets Irs1, prompts apoptosis in both pancreatic tissue of diabetic SD rats and INS1 cells treated with palmitic acid, down-regulation of miR-139-5p contributes to the anti-apoptotic effect induced by Liraglutide via targeting Irs1.

Biography:

Cong-Yi Wang, MD, PhD, Professor and Director, the Center for Biomedical Research, Vice Director, Department of Sponsored Program Administration, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology. Before 2014, he served as a tenured Associate Professor at the Department of Pathology, and the Director of Georgia Esoteric & Molecular Laboratories, LLC, Georgia Regents University, USA. The major focus for his research is to dissect the role of genetic and epigenetic factors in the pathogenesis of diabetes and diabetic complications. Particularly, he employs animal models and human subjects to address how environmental insults interact with genetic factors to modulate disease susceptibility, and through which to develop effective therapeutic approaches for prevention/intervention of these devastating disorders.

Abstract:

Type 1 diabetes (T1D) is resulted from the interaction of susceptible genes and environmental factors. DNA methylation acts as a footprint to link susceptible genes and environmental factors, and encodes information beyond DNA to record the impact of environmental insults on DNA, which is interpreted by the methyl-CpG binding domain (MBD) proteins in a cell and gene-dependent manner. Particularly, MBD2, one of the MBD proteins, is preferentially induced upon pathological insults, which then deciphers DNA methylome-encoded information to modulate disease susceptibility. MBD2 was found to regulate the homeostasis of CD4 T cell differentiation and functionality, and mice deficient in MBD2 were completely protected from MOG35-55 induced experimental autoimmune encephalomyelitis (EAE). On the other hand, NOD mice deficient in MBD2 showed exacerbated T1D. Mechanistic studies revealed that MBD2 selectively binds to the methylated CpG sites at the T-bet and Hlx promoter, and by which it suppresses the transcription of IFN-γ. As a result, loss of MBD2 leads to altered IFN-γ expression, which then renders naïve T cells preferentially differentiating to Th1 cells along with impaired Th17 development. Moreover, elevated Hlx transcriptional activity resulted from MBD2 deficiency synergizes with T-bet to mediate IFN-γ expression in IL-4 producing Th2 cells. In patients with fulminant T1D, environmental insults in genetic predisposed subjects triggered Foxp3 promoter hypermethylation, which then prevented IRF-7 binding to the Foxp3 promoter, thereby impairing the development and functionality of regulatory T cells (Tregs). Collectively, these discoveries demonstrate how environmental factors trigger autoimmune responses during T1D development.

Biography:

Zehra Gok Metin has completed her PhD in 2015 from Hacettepe University and stayed for one year at University of Alabama at Birmingham for Post-doctoral studies. She is an Instructor at Hacettepe University Faculty of Nursing. She is working on Symptom Management especially for pain for five years. She has several publications in reputed journals and has been serving as a reviewer for reputed journals. 

Abstract:

Purpose: This study aimed to examine the effects of aromatherapy massage on neuropathic pain severity and quality of life in patients suffering from painful diabetic neuropathy.

Design & Methods: This randomized controlled clinical study was conducted in a university hospital endocrine outpatient clinic in Turkey. The sample of the study consisted of totally 46 patients, randomly allocated to the intervention group (n=21) and the control group (n=25).  The intervention group received aromatherapy massage three times in a week during a duration of four weeks. Control group did not receive any intervention without usual care. Data were collected using the patient questionnaire, Douleur Neuropathique Questionnaire, Visual Analog Scale and Neuropathic Pain Impact on Quality of Life Questionnaire.

Findings: Neuropathic pain scores significantly decreased in the intervention group compared with the control group in the 4^th week of the study. Similarly, quality of life scores significantly improved in the intervention group in the 4^th week of the study.

Conclusions: Aromatherapy massage is a simple and effective nonpharmacological nursing intervention that can be used to manage neuropathic pain and improve quality of life in patients with painful neuropathy.

Clinical Relevance: Aromatherapy massage was a well-tolerated, feasible, and safe nonpharmacological method that could easily be integrated into clinical settings by nurses. However, long-term effects and follow-up procedures should be added in clinical study designs to support clinical usage of aromatherapy massage.

Biography:

Soha M Abd El Dayem has international experience in various programs, contributions and participation in different countries for diverse fields of study. Her research interests reflect in her wide range of publications in various national and international journals.

Abstract:

Objective: To evaluate leptin and lipid profile in overweight type 1 diabetic patient.

Patients & Methods: The study included 50 overweight type 1 diabetic patients and 50 age and sex matched healthy controls. Blood sample was taken for evaluation of glycosylated hemoglobin, lipid profile and leptin. Also, urine sample was taken for evaluation of albumin/ creatinine ratio.

Results: Leptin level was significantly lower in overweight diabetic patients and had a significant positive correlation with hip circumference and body mass index and negative correlation with HbA1c. Leptin level was significantly lower in overweight diabetic patients with HbA1c > 7.5 %. The best cut off point between overweight diabetic group and control group regarding level of leptin was found 16.9 with sensitivity 68% and specificity 56% and also area under curve 0.623.

Conclusion: leptin level is low in overweight diabetic patients and it is related to body mass index and hip circumference.  LDL-c level was significantly increased while HDL-c level was significantly decreased in the diabetic overweight group indicating increased risk of cardiovascular disease. Leptin level in overweight diabetic patients is related to metabolic control.

Biography:

Abstract:

Objective: To evaluate the relationship of plasma level of nesfatin,  chemerin and vaspin to early atherosclerotic changes. Also to evaluate chemerin and vaspin genotype and to detect its relation to glycemic control and atherosclerosis in adolescent type 1 diabetic patients.

Patients & Methods: The study included 70 type 1 diabetic patients and 30 age and sex matched healthy volunteers. The mean age of patients was 17.99±2.59, mean duration of diabetes was 10.91±3.54, mean onset of disease was 7.00±3.28. Blood samples were taken for assessment of chemerin, nesfatin, vaspin, and oxidized low-density lipoprotein (OxLDL) by enzyme linked immunosorbent assay (ELISA) technique. Also, blood samples were taken for analysis of glycosylated hemoglobin (HbA1); lipid profiles and urine samples were taken for assessment of albumin/creatinine ratio. Carotid (cIMT) and aortic (AIMT) intima-media thickness were also done.

Results: Nesfatin, chemerin, vaspin, OxLDL, and albumin/creatinine ratio, cIMT and AIMT were significantly higher in diabetic patients. HbA1 and cIMT were significantly higher in TT genotype of chemerin than GG genotype (9.50±1.99 vs. 8.34±1.62 and 0.54±0.06 vs. 0.50±0.04 respectively). Chemerin and vaspin had a significant positive correlation (r=0.2, P=0.05), nesfatin and LDL (r=0.3, P=0.05) and Vaspin and body mass index (r=0.3, P=0.01).

Conclusion: Diabetic patients had increased level of adipocytokines and are liable for early atherosclerosis. TT genotype in diabetic patients is associated with poor glycemic control and early atherosclerosis.

Biography:

Eustache Paramithiotis completed a PhD in Immunology from McGill University and Post-doctoral research at the Howard Hughes Medical Institute at the University of Alabama at Birmingham with an award from the Irvington Institute for Immunological Research. He has extensive experience in large scale biology and translational medicine, in particular biomarker discovery and validation, and has led several privately or publically funded multi-year projects. He is currently the Caprion’s Vice President of Biomarker discovery and Diagnostics, responsible for the advancement of Caprion’s diagnostics development pipeline and for discovery of biomarkers with diagnostic application potential.

Abstract:

Pancreatic islets play a critical role in diabetes disease development. Their status is currently approximated through measurements of basal and stimulated blood glucose, C-peptide, and insulin levels. Glycated hemoglobin (HbA1c) levels are used to estimate disease progression and response to therapy. These tests are either insufficient, or impractical to perform in a clinical setting. Therefore, an important unmet need remains for biomarkers that can accurately monitor the function and health of pancreatic islets. Such biomarkers may help predict disease progression, guide drug selection, monitor therapeutic efficacy and accelerate the development of disease-modifying therapies that aim at improving the function of -cells.  We have identified candidate blood biomarkers associated with pancreatic islet function by proteomic analysis of secretory vesicles isolated from primary human pancreatic islets under steady state and following induced dysfunction. Candidate specificity was evaluated by comparing the pancreatic islet datasets to a library of secreted proteins produced by multiple major organs and selecting the proteins uniquely present in pancreatic islets. The performance of the biomarkers was assessed using targeted multiple reaction monitoring mass spectrometry (MRM-MS) or ELISA in plasma from patients that were either normoglycemic (n=47), had impaired glucose tolerance (n=17), or were Type 2 diabetics diagnosed for less than 1.5 years (n=19) or for over 5 years (n=28). A pool of 14 candidates was able to accurately classify patients into the disease progression groups when used in small combinations of 3-5 biomarkers. This performance was independent of and superior to the standard of care (SOC; glycated hemoglobin and fasting plasma glucose). This performance improvement was especially important for pre-diabetic patients where about 50% can be currently be correctly identified by the SOC. Most candidate biomarkers had functions related to metabolic homeostasis or regulation of islet secretion, tissue remodeling, and inflammation. We have thus identified candidate biomarkers derived from human pancreatic islets that appear able to distinguish between disease progression groups. Independent confirmatory studies are underway using cross-sectional groups from a different clinical site as well as longitudinal cohorts of patients with gestational diabetes or who underwent bariatric surgery.