Day 2 :
Keynote Forum
Omo Ojo
Keynote: The Role of Exenatide in Managing Cardiovascular Risks and Complications in Patients with Type 2 Diabetes
Time : 10:00-10:30
Biography:
Dr Ojo has a PhD in nutrition, a post graduate diploma in diabetes and a graduate certificate in Higher Education. He is a Senior Lecturer in Primary Care and teaches across a range of courses and programmes in the school. His key interest and areas of expertise are diabetes and nutrition which form the focus of his research and teaching activities. Dr Ojo leads the school Diabetes Specialist Interest Group and co-ordinates the Diabetes Care and Management course for post registration nurses and Patient Pathways of Care for pre-registration participants.rnHe supervises both undergraduate and postgraduate research students including PhD students. His research interests are reflected in his 25 publications in reputed journals and 9 conference presentations. His work is recognised both nationally and internationally and he has been a keynote speaker at the NNNG conference, a reviewer for Journals and sits on the Editorial Board on a number of International Journals. rn
Abstract:
The aim of this systmatic review is to examine the role of exenatide BID in managing cardiovascular risks and complications in patients with type 2 diabetes.rnMethod: This involved a literature search including a general scoping of the data bases which found previous reviews relevant to the population and intervention of interest, but these were either more than 4 years old, were narrative reviews or included liraglutide and studies which were not randomised. The current systematic review is based only on randomised controlled studies. rnrnThe literature search strategy for the review relied on previously published guidelines for reviews and was based on the Population (P), the Interventions (I), Comparative interventions (C) and Outcomes (O) (PICO) framework. A number of databases including EBSCO host, encompassing Academic search premier, Medline, Psychology and Behavioural sciences collection, PSYCINFO, SPORTDISCUSS and Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus were accessed.rnIn addition, ‘Boolean’ search strategy allowing the combination of search terms such as ‘Exenatide’ AND ‘Diabetes’ AND ‘cardiovascular diseases’; ‘Exenatide’ AND ‘Diabetes’ AND ‘glycaemic control’; ‘GLP–1’ AND ‘Diabetes’; ‘GLP–1’ AND ‘Diabetes’ AND ‘cardiovascular diseases’; ‘GLP–1’ AND ‘Diabetes’ AND ‘macrovascular diseases’; ‘Exenatide’ AND ‘Cardiovascular risks’; ‘Exenatide’ AND ‘Cardiovascular complications’; Exenatide’ AND ‘ glycaemic control’ was used.rnThe quality of the studies selected were evaluated using the checklists for quantitative studies.rnTen (10) randomised controlled studies which met the inclusion criteria were selected for the current review. rnThe outcome measures included in the search were; Cardiovascular risks, Cardiovascular complications, glycaemic control.rnAll the studies reviewed except 1 showed that the use of exenatide BID as a monotherapy or in combination with other medications was associated with reduction in most cardiovascular risks and complications such as weight, blood pressure, glycated haemoglobin which are associated with type 2 diabetes compared with control.rnrn
Keynote Forum
Belma Turan
Ankara University, Turkey
Keynote: Cardiac β-adrenoceptor subtypes in diabetes: Regulation of cardiac β3-adrenergic receptors
Time : 10:00-10:30
Biography:
Belma Turan has completed her PhD at the year of 1982 from Ankara University and postdoctoral studies from INSERM France and University of Ottawa School of Medicine. She is Professor and the Head of Biophysics Department in Ankara University Faculty of Medicine. She has published more than 100 papers in reputed journals and has been serving as an editorial board member of more than 10 international journals. She is also fellow of International Academy of Cardiovascular Sciences since 2005. She has been supervised over 20 PhD and MSc thesis. Her research interest is focused on cardiac electrophysiology, calcium and zinc ion regulations, oxidant stress, antioxidants, diabetic cardiomyopathy
Abstract:
Positive inotropic action of catecholamines is mediated through their interaction with beta-adrenergic receptors (β-ARs), while they can also mediate some deleterious effects, such as cardiac arrhythmias. The β-ARs are members of the G protein-coupled receptors and play important roles in the regulation of heart function. Cellular signaling associated with cardiac β-ARs is composed of coupled mechanism between β1-/β2-AR and Gs proteins with contribution of constitutive β3-AR coupling to Gi proteins. This coupled mechanism further leads to the activation of adenylyl cyclase, and thereby increases in intracellular cAMP level. However, recent studies have emphasized the contribution of constitutive β3-AR coupling to Gi proteins, thereby initiating additional signal transduction pathways, particularly under physiopathological conditions such as hyperglycemia. Diabetic cardiomyopathy, as a distinct entity, is recognized due to its diminished responsiveness to β1-AR agonist stimulation in the heart from diabetic rats with no important changes in the responses mediated with β2-AR. Furthermore, an upregulation of β3-AR has been shown in diabetic rat heart with a strong negative inotropic effect on left ventricular function. Experimental data provide evidences that the mechanisms for the negative inotropic effect with β3-AR activation appears to involve activation of a nitric oxide synthase pathway. On the other hand, we have shown that although insulin resistance and cardiomyopathy are developed under high-carbohydrate diet-induced metabolic syndrome (MetS), compared to type 1 diabetes, MetS-associated cardiac dysfunction seems not to be associated with any change in β3-AR system, with similar ultrastructural changes into the myocardium
Keynote Forum
Vladimir Strbak
Slovak Medical University ,Slovakia
Keynote: Insulin Regulatory Secretory Pathway: Role of Thyrotropin Releasing Hormone
Time : 10:00-10:30
Biography:
Vladimír Strbak,MD and DSc., has completed his study in Bratislava. He was Director of the Inst. Exp. End.SAS, Head of Pathological Physiology, Slovak Med. Univ., president of the Slovak Physiological Society, Council Member FEPS, chair of the Scientfic Board of the Slovak Academy of Sciences for Medical Sciences, Council Member of the International Society for Pathophysiology. Published 118 PuBMed papers. Organized series of symposia on Hormones in Milk (5) and Cell volume and function (2) and FEPS meeting in Bratislava. He served as Organizing Committee member of the 6th Global Diabetes Summit and Medicare Expo in Dubai (2015).rn
Abstract:
Thyrotropin-releasing hormone (TRH) was found in various locations. Pancreatic TRH is colocalized with insulin in the secretory granules of ï¢ cells. High TRH expression in the pancreatic islets in perinatal rat coincides with maturation of the insulin secretory responsiveness to glucose. Prepro-TRH gene disruption in mice results in hyperglycemia, accompanied by impaired insulin response to glucose. We showed that secretion of TRH from islets is stimulated by glucose and inhibited by insulin or somatostatin. These data indicate specific relation between TRH and glucose-induced insulin secretion To induce acute shortage of TRH we blocked the terminal step of the post-translational TRH maturation in adult rat in vivo by disulfiram (DS, 5 day i.p. 200 mg/kg pretreatment) and tested insulin secretion from isolated islets in vitro. TRH in physiological concentration (1 nM) did not affect basal or glucose stimulated insulin secretion. Release of insulin from DS-treated pancreatic islets under basal (unstimulated) conditions was four times higher compared to controls and could not be further stimulated by high-glucose. Addition of 1nM TRH in the incubation medium decreased basal insulin secretion to control levels and normalized response to 16.7 mM glucose of islets from DS treated rats. We conclude that TRH is essential for insulin direction from constitutional to regulatory secretory pathway. This function might be disturbed in diabetes mellitus 2.
Keynote Forum
Udaya Kabadi
University of Iowa, USA
Keynote: Diabetes Mellitus: Disorder of cellular dysfunction due to lack of entry into cell of glucose; the most efficient fuel for cellular function.
Time : 11:20 - 11:50
Biography:
Dr. Udaya M Kabadi completed general medicine residency at KEM Hospital and obtained post graduate degree MD from Mumbai University, Mumbai, India. He continued his post graduate training in internal medicine and fellowship training in New York, NY, USA. He is Board certified in Internal Medicine, Endocrinolgy and Metabolism and Geriatric Medicine by American Board of Internal Medicine. He is Fellow of American College of Physicians, American College ofr Endocrinolgy and Royal College of Physicians of Canada. He is an Adjunct Professor of Medicine at Des Moines University, Des Moines,rnrnIowa and University of Iowa, Iowa, USA. He has authored over 190 papers in peer reviewed medical journals and 2 books. He has conducted over 500 CME presentations and chaired symposia at Regional. National and International Meetings. He serves as a member of Editorial Board of many Medical Journals. He has also been elected ' Teacher of The Year' by undergraduate students and postgraduate trainees on several occasions during his career.
Abstract:
Traditionally, diabetes Mellitus has been deemed to be a chronicrnrnhyperglycemic disorder secondary to altered glucose metabolism. Alternatively, hyperglycemia may be one of several manifestations inrnrnsubjects with type 1 and type 2 diabetes Mellitus. Almost all tissuesrnrnrequire insulin for entry of glucose, the possible exceptions being redrnrnblood cells, renal medulla as well as central and peripheral nervousrnrnsystems. Hyperglycemia in intravascular compartment and otherrnrnextra cellular milieu may be attributed to impaired glucose entry intornrnendothelial cells of the vessel wall and almost all other cells includingrnrnhepatocytes, myocytes of all varieties, adipocytes and individual cellsrnrnin most other organs respectively due to absence of insulin in type1rnrnand both the insulin resistance as well as the decline in both phasesrnrnof insulin secretion in type 2 Diabetes. Albeit, the decline in bothrnrnphases of insulin secretion are induced by lack of glucose entry intornrnpancreatic beta cells. Finally, hyperglycemia is perpetuated byrnrnincreased hepatic glucose production caused by into sustainedrnrncirculating hyperglucagonemia secondary to lack of glucose entryrnrninto the pancreatic alpha cells. Alternatively, both the decline inrnrninsulin secretion by the beta cells and the rise in glucagon release byrnrnthe alpha cells are enhanced by fall in GLP1 and GIP caused byrnrndysfunction of L cells and K cells respectively secondary to lack ofrnrnglucose entry in both type 1 and type 2 diabetes. Similarly, increasedrnrnprevalence of infections and thromboembolic micro andrnrnmacrovascular events may be attributed to dysfunction of leukocytesrnrnand platelets respectively due to impaired glucose entry. Finally,rnrnalterations in several other metabolemics including serumrnrnconcentrations of Adiponectin (Adipose cells), TNF alpha,rnrnPlasminogen inhibitor factor 1, Homocysteine, CRP, Lipids etc (rnrnHepatocytes) as well as dysfunction of several organs ( liver, heart,rnrnkidney, adrenal, pituitary, lungs etc) in both type 1 and type 2 diabetesrnrnmay also be attributed to the lack of glucose entry into these specificrnrncells. This hypothesis is validated by improvement in metabolemicsrnrnand organ function on facilitation of glucose entry into cells by insulinrnrnadministration and / or improvement in insulin sensitivity. Therefore,rnrnin conclusion, diabetes mellitus is a disorder manifesting dysfunctionrnrninvolving almost all organs and cells induced by lack of entry ofrnrnglucose, the most efficient substrate for cellular function.
Keynote Forum
Gaurav Sharma
DrG Wellness, India
Keynote: The Future of Type 2 Diabetes Management- Today and what to expect tomorrow
Time : 11:50 - 12:35
Biography:
Dr. Gaurav Sharma is a renowned Diabetologist and a lifestyle doctor who is credited with changing the entire wellness industry across the globe. He is one of the illustrious personalities known for his contribution towards society & making people aware about the perpetual dominance of a number of lifestyle related disorders. A visionary by approach & innovator by default his urge of giving back to society inspired him to launch DrG Wellness, a company which has motto of constant innovation in terms of pathbreaking food supplement & products. Dr. G Wellness has dedicated R & D team which is headed by Dr. G Sharma himself. After completion of his post graduation (M.D) from St. Petesburg state medical academy, he heralded a profound need for people to lead a healthy lifestyle by adopting the right diet plans. He was always keen towards working for the benefits for those suffering from most prevalent lifestyle related disorders like diabetes, arthritis, obesity. He has been practicing for more than 14 years in preventing and managing such disorders through his world famous lifestyle modification programs. He was recently awarded at the 4th M.T India health care awards held in 2014 to become the most admired Diabetologist and lifestyle doctor. Dr. G feels “Impossible is equal to opportunity” & this is what has inspired him to innovate products which have reversed diabetes and arthritis of thousands of patients. Dr. G Sharma has been featured numerous times on the leading national television discussing how to reverse the symptoms of most lifestyles related disorders naturally
Abstract:
Diabetes mellitus (DM) is a metabolic disorder in the endocrine system with a defect in the insulin secretion or action or both which leads to increase in blood sugar in the body. At present, Type 2 diabetes mellitus (T2DM) is the predominant form of DM that accounts for 90–95% of diabetic patients globally. The standard therapy for T2DM includes balanced diet, appropriate exercise, and more importantly, the use of oral hypoglycaemic drugs, and/or subcutaneous insulin injections. Use of anti- diabetic drugs have lead to concerns about their potential toxicity and side effects such as weight gain, bone loss, and increased risk of cardiovascular events.rnNutraceutical supplement is one of the upcoming approaches towards the control and reversal of diabetes worldwide. Diabetall & Diabetplus are magical supplements that work as a sure shot adjuvant with no side effects. They not only regulate and maintain the blood sugar levels through various pathways but also reverses the effect of T2DM which is evident through our in house clinical trials.rnHere we emphasize on how the use of natural therapy that includes supplements with botanical extracts, dietary modifications and exercise programs and counselling help to reverse the effect of diabetes and also promote a sense of well being in individuals.rn