16^th Global Diabetes Conference and Medicare Expo March 22-23, 2017 Rome, Italy

Biography:

Frank Christopher Howarth has obtained his PhD in Cardiac Physiology from the University of Central Lancashire in 1994, and has completed his Post-doctoral studies from Bristol and Leeds University, UK. Since 1998, he has been working in the Department of Physiology, College of Medicine and Health Sciences, UAE University. Diabetes and heart function has been a major focus of his research for almost 20 years. His laboratory has been supported by more than 40 international and national grants. He has published more than 100 papers and book chapters.

Abstract:

The left ventricle of the heart pumps blood at higher pressure than the right; the electromechanical properties of ventricular myocytes vary transmurally. The differences in electromechanical properties could be related to differences in stress and strain across the walls of the ventricles. Many studies have reported that muscle contraction and electrical conduction are frequently altered in the diabetic heart and disturbances in calcium transport partly underlie mechanical dysfunction in the diabetic heart. To date, most of the single cell studies in diabetic heart have been performed in myocytes that have been isolated from whole ventricle. Very little is known about the transmural effects of diabetes on the heart. A recent study performed in our laboratory investigated the contraction and calcium transport in epicardial (EPI) and endocardial (ENDO) myocytes from left ventricle of streptozotocin (STZ)-induced diabetic rat heart. These experiments were performed in relatively young animals after 12 weeks of STZ treatment. Differences were observed in the time course of contraction and calcium transport in EPI and ENDO ventricular myocytes of diabetic heart compared to control heart. We are currently using video edge detection, fluorescence photometry and whole-cell patch-clamp techniques to investigate contraction and calcium transport in EPI and ENDO myocytes isolated from left ventricle in two experimental models of diabetes. The STZ-induced diabetic rat, a model of type 1, after 20 weeks of STZ treatment and the Goto-Kakizaki rat, a model of type 2, aged 12 months. The results of these studies will be presented.

Biography:

Elisa Roesti has completed her BSc and MSc in Molecular Biology from the University of Basel in 2015. She is currently in the lab of Professor Dr. Martin Bachmann as a PhD candidate investigating the role of virus-like particle (VLPs) as vaccine platforms against chronic diseases, in particular against type 2 diabetes mellitus.

Abstract:

Amyloid aggregates composed of extracellular fibrils of islet amyloid polypeptide (IAPP, also called amylin)- a peptide synthetized in the pancreatic β-cells and co-secreted with insulin are found in most type 2 diabetes mellitus (T2DM) patients and has been associated with the progression of the disease. As aggregates are considered to be a key factor in β cell death, we aim at developing a vaccine targeting these pathogenic aggregates to prevent and/or reverse accumulation and enhancing β cell survival. To study this, a transgenic mouse model expressing human IAPP (hIAPP) is used. The vaccines were designed using amylin peptide sequences chemically cross-linked to virus like particles (VLPs). To test the induced antibodies response against each peptide, C57BL/6 mice were immunized and the serum antibodies were analyzed by ELISA assay. The peptides coupled to the VLPs inducing the highest IgG titers against IAPP were tested in the mouse model. Monitoring analysis of the transgenic mice showed spontaneous development of T2DM around the 8^th week of age only in the homozygous male group. For this reason, immunizations with the vaccine were performed only in these mice. Interestingly, the first analyzed group of immunized male transgenic mice showed no symptoms of T2DM up to 12 weeks. We are currently repeating these experiments to assess inflammatory state, hIAPP load and disease progression.

Biography:

David Probst has done his Engineering from Arizona State University, USA. He has done his MS and BS in Electrical Engineering from the Western New England University. He is currently an Assistant Professor in the School of Biological Health and Systems Engineering, and at the Biodesign Institute of Arizona State University. He is currently working with Dr. Labelle at the Arizona State University, USA. He has worked with various markers such as glucose, glucagon and insulin. At present, he is working on the multi-marker design and publication.

Abstract:

Diabetes is one of the largest epidemics in the world affecting over 422 million people worldwide, with quickly increasing prevalence. In order to help combat the ever growing amount of patients, many new technologies are being suggested to help monitor and treat the disease. In the Labelle Group, we are currently developing electrochemical sensors for noninvasive glucose sensing. Our design ranges from tear glucose sensors to measure blood glucose noninvasively, to a multi-marker sensor that adds more depth for self-monitoring glycemic devices. These markers such as glucose, HbA1c, insulin, and many others are simultaneously monitored on a single disposable strip sensor. Specifically, we suggest using third generation biosensing integrated with electrochemical impedance spectroscopy (EIS), which is a novel detection platform capable of multi-marker detection through the application of voltage at varying frequencies. Utilizing real and imaginary impedance as separate entities, a calibration curve can be derived with high sensitivity and specificity at the chosen characteristic frequency. The ability to detect multiple analytes simultaneously is due to the ability to deconvulute the output impedance signals at these varying frequencies. The process is performed through immobilizing various molecular recognition elements onto a single working electrode followed by scanning a range of frequencies 1.18 Hz up to 100 KHz, and selecting characteristic peaks. Currently, this has been used to characterize many diabetes related biomarkers such as glucose, insulin, lactate, glucagon, IGF-1, as well as multi-marker LDL/HDL co-immobilization. This type of system would greatly affect the quality of life, and more specifically the control of glycemic levels.

Biography:

P R Raghavan is the CEO of Nanorx Inc., and has a PhD in Organic Chemistry from Oregon State University (1979). He has done his MS in Chemistry (1972) from IIT Mumbai, India. He has worked on Drug Discovery for over 25 years at Columbia University; Max-Planck Institute, Germany; Ciba-Geigy (now Novartis), and Boehringer Ingelheim.

Abstract:

Metadichol (US patent 8,722,093) is a nano emulsion of long-chain alcohols found in many foods. It is commonly called policosanol and is present in foods such as rice, sugar cane, wheat and peanuts. Metadichol acts on nuclear vitamin D receptors (VDR) (US patent 9,006,292) that are present in cells throughout the body to stimulate the immune system and inhibit a variety of disease processes. Vitamin D deficiency has been shown to alter insulin synthesis and secretion in both humans and animal models. Anti-diabetic activity of Metadichol® in ZDF rats showed reduction in fasting glucose levels and decreased insulin resistance. In addition, it increases insulin production and also reduces insulin in cases of hyperinsulinemia. Case studies of type 1, type 2 diabetes and gene expression analysis will also be presented. Metadichol consists of natural components of common foods and has no known negative side effects; Metadichol has the potential to serve as a novel, treatment for insulin related diseases. It has the potential to serve as a novel treatment for diabetes related diseases that confront public health today.

Biography:

Kurnikova I A is a Doctor of Medical Science (since 2010). She has worked on the problems of endocrinology for over 20 years. She was the Head of Endocrinology department at the Russian Scientific Center of Medical Rehabilitation and Health Resort (Moscow, Russia). Currently, she teaches at the Peoples' Friendship University of Russian and Curator of the Scientific Direction Endocrinology. She has published more than 20 articles in reputed journals, and author of 25 books and tutorials in Russian language.

Abstract:

Objective: The objective of this study is to determine the prediction of autonomic regulation parameters in diabetic patients.

Methods: Study involved 112 patients with type 2 diabetes (DM2) and 46 with type 1 diabetes (DM1). Glycemic level was controlled by WHO recommendations to evaluate heart rate variability spectral analysis. Method of estimating the base component of the rehabilitation potential- morphology function index (MFI) was used to assess prognosis of disease.

Results & Conclusion: Poor compensation of diabetes resulted in significant changes in HR variability, but direction and severity of disorders in patients with different types of diabetes was not same. The circadian index in patients with DM2 was less, which is possible only with the express violation of the central and autonomic regulation. High power frequency is typical for severe vegetative neurosis and disruption of the autonomic regulation. Decompensation of DM1 was not reflected in the CI, but was accompanied by reduction of the total power spectrum. Factor of vagosympathetic balance on the background of decompensation was higher than average. In patients with DM2 decompensation, and accompanied by autonomic imbalance, proceeded against the backdrop of the increased activity of parasympathetic nervous system. A number of indices for the rehabilitation of adverse prognosis (MFI-1) patients with DT1-TC<1500 ms² (RR=2.5), VLF<50% in the structure of the spectrum (RR=1.46), LF/HF-3.0 (RR=1.77), IC -3.50 (RR=3.52), the index of regulatory systems tension (RR=3.1). In patients with DM2, symptoms of autonomic dysfunction were observed with the onset of the disease.

Biography:

Amritha M K has completed her MBBS from Bangalore University and MD in Internal Medicine from Kuvempu University, India. Based on her research interest she completed Diploma in Diabetology from Vinayaka University and Post Graduate certificate course training in Diabetic Foot from AIMS (Kochi). Her practice in Diabetes and Diabetes Foot Ulcers has led her to innovative methods of treatment. She is currently working on Innovative Methods of Treatment of Diabetic Ulcers and her are of interest is usage of Mistletoe therapy in gangrenous diabetic foot lesions.

Abstract:

Many a time treatment of a diabetic foot ulcer is influenced by co-morbidities restricting the outcome and the application of multilevel therapies leading to poor results. Here is a presentation of a diabetic male 56 year old, who was presented with an ulcer above the right lateral malleolus with a duration of 12 weeks, non-healing along with co morbidities of cyanotic congenital heart disease with secondary polycythaemia, chronic kidney disease, retinopathy and hypertension, managed in a diabetic foot clinic without drugs. From second treatment day onwards wound started showing improvement. Ulcer surface area, ulcer depth and pain intensity started decreasing. After 27 sessions of infrared LED light for 30 minutes and pulsed electromagnetic field for 45 minutes complete healing of the wound occurred. Infrared LED light therapy delivers monochromatic infrared light and visible LED light. This is known to increase microcirculation stimulate production of collagen, stimulate fibroblastic activity, increase lymphatic activity. Pulsed electromagnetic field therapy produces very low frequency electromagnetic waves of 1500 nanoteslas. Extremely low frequency magnetic fields have been known to induce cytoprotection and repair. ELF-EMF (extremely low frequency electromagnetic field) induces keratinocyte proliferation and modulates chemokine production through inhibition of NF KB signaling pathway and this may inhibit inflammatory process. Non healing ulcer in a diabetic individual leading to lower extremity amputation has been well documented. Co-morbidities like cyanotic congenital heart disease; chronic kidney disease, etc., contributes to poor healing of the ulcer.

Biography:

Mayvor Ström has completed her PhD from the Sahlgrenska Academy, Sweden in 2009. She is a Trained Nurse/Midwife in service with a Master's degree in Environmental Medicine. She has lot of experience in advising patients regarding medical care over telephone (helpline). She thinks that the daily care meeting is crucial and a very important part of overall care.

Abstract:

Telephone consultations with specially trained nurses are becoming an increasingly common form of care. The aim of this study is to describe patients’ perceptions of receiving advice via a medical care helpline. The patients perceived the helpline as a professional, reliable and easily accessible asset in everyday life, as self-care is promoted through personal advice and the helpline is a partner with whom one can discuss reflections and feelings. It is also a kind of “back up”. The advice service is perceived as satisfactory when the nurse is calm, friendly, confirming and shows respect. Compliance and acceptance are enhanced when patients feel involved in the decision-making process. The fact that the service is easily accessible hence makes it simple and time-saving. As per the patient’s perspective, the telephone contact with the helpline is a simple, easily accessible and secure alternative that is appreciated and used. Caring encounters give rise to feelings, influenced by the agreement between one’s own needs and expectations, the encounter between human beings and the care provider. More in-depth studies are needed focusing on the patient’s perspective and characterization of the caring encounter over the telephone. Improved understanding of the patient’s perspective on the care provided leads to increased staff satisfaction and motivation. Care encounters through phone are common today for nurses and their well-being at work is beneficial for both them and the care they provide and thereby for the patients.

Biography:

Ishrat Jahan Saifi is pursuing her research under the supervision of Dr. Sheelu Shafiq Siddiqi, Associate Professor and Director at Rajiv Gandhi Centre for Diabetes and Endocrinology, J N Medical College and Hospital, Aligarh Muslim University, Aligarh, India. She has completed her Post-graduation in Biochemistry from Integral University Lucknow, India. She has presented three research papers and has participated in various seminars/conferences held in India. She has published one research paper as a co-author.

Abstract:

Diabetes is a metabolic disease; it results due to lack of insulin production, insulin action or both. It became epidemic in all over the world. Glycation of proteins is a major contributor to development of diabetes mellitus. HSA is the abundant protein in human blood; it is highly prone to glycation by the reducing sugars in-vitro and in-vivo in hyperglycemic condition. 2-deoxy D-ribose (dRib) is a reducing sugar having high reactivity with protein and it is present in the human blood. In present study, HSA was incubated with different concentrations of dRib at 37ºC for 4 hours. Structural changes in HSA were determined by UV­ spectroscopy, fluorescence spectroscopy, circular dichroism (CD) and Fourier transform infrared spectroscopy (FTIR). To determine the role of dRib modified HSA in diabetes mellitus, immunological study has been done with the patients sera. We observed preferential binding affinity in the modified HSA coated wells as compare to native HSA coated wells. Thus, it can be concluded that dRib is potent enough to cause structural changes as well as generation of neoepitopes on the protein which may induce antibodies in diabetic patients and might play a role in the onset and progression of diabetes.

Biography:

Zafar H Israili has completed his PhD in Medicinal Chemistry from the University of Kansas and has completed his training in Clinical Pharmacology from Emory University School of Medicine (EUSM). He is an Associate Professor of Medicine at EUSM and an Adjunct Professor of Chemistry at Georgia State University. He is also a Visiting Professor at the University of Fez, Morocco. He has work experience as an Adjunct Professor in Chemistry at the Emory University; Adjunct Professor in Pharmacology at Morehouse School of Medicine and as a Research Pharmacologist at Veterans Administration. He is an Associate Editor of Journal of Hypertension; Latin American Journal of Hypertension and Guest Editor of International Journal of Hypertension. Previously, he was the Editor of Ethnicity and Disease, Associate Editor/Editorial Board Member of Drug Metabolism Reviews and Drug Development Research. He is a reviewer for more than 60 medical- and scientific journals. He has published 177 research papers, reviews and book chapters.

Abstract:

Diabetes, one of the most common endocrine metabolic disorder (285 million diabetics), affects the eyes, kidney, brain, heart, limbs and the nervous system. Presently available antidiabetic drugs (insulin, sulfonylureas, biguanides, thiazolidinediones, GLP-1 mimetics/analogs, DPP-4 inhibitors, meglitinides, amylin analogs, SGLT2 inhibitor and α-glucosidase/aldolase/reductase/amylase inhibitors) become less effective over time and also have safety and tolerability issues. Worldwide about 800-1200 plants (herbs) reported to be used to treat diabetes, are low cost, readily available, and perceived to be non-toxic. The mechanisms of hypoglycemic action of many of these plants are similar to those of the conventional antidiabetic agents: 1) Insulin-like activity (Cinnamomum cassia/C. zeylanicum, etc.); 2) Insulinotropic effect (Stevia rebaudiana Bertoni); 3) Insulin sensitization (Momordica charantia, S. rebaudiana Bertoni, Synsepalum dulcificum); 4) Induction of insulin-like glucose transport into adipocytes (Lagerstroemia speciosa); 5) Alpha-glucosidase inhibition {Acosmium panamense (Benth.), M. charantia]; 6) Aldolase reductase inhibition (Cecropia obtusifolia Bertol., Fructus Arctii); 7) Alpha-amylase (pancreatic) inhibition (Azadirachta indica, Eugenia jambolana); 8) Liver gluconeogenesis inhibition (M. charantia and S. rebaudiana); 9) Increasing GLP-1 binding to receptor (Artemisia dracunculus L.); 10) PPAR-γ agonist (Punica granatum, Vaccinium angustifolium Aiton.); 11) Dual-PPAR-α/γ agonist activity (P. granatum); 12) Inhibition of sodium-dependent glucose cotransporter-2 (Nigella sativa seeds); 13) Inhibition of acetyl-CoA carboxylase (Persea americana Mill); 14) Activation of AMP-activated protein kinase (M. charantia), etc. Shortcomings of plant medicine include, diagnosis and therapeutic effectiveness mostly based upon symptoms and relief of symptoms, lack of standardization for quality, dosing, and efficacy, and toxicity may ignored or not recognized.

Biography:

Mahir Jallo is a Clinical Professor of Medicine and Senior Consultant Endocrinologist at the Gulf Medical University UAE. He has done his MB and ChB from Mosul Medical College, Iraq. He got his Arab Board Certificate (CABM) in Internal Medicine, and is certified with Diploma in Dyslipidemia from Boston University School of Medicine, USA. He is an Editorial Board Member for many international Diabetes and Endocrinology journals and Principle Investigator for many national and international clinical studies.

Abstract:

The prevalence of type 2 diabetes (T2D) is progressively increasing because of a concomitant rise in the prevalence of obesity. Globally, approximately 80% of people with T2D are overweight or obese. It is recommended that such individuals lose around 5-10% in order to improve glycemic control, as well as reduce their risk of other health conditions. Intentional weight loss in patients with T2D has been associated with a 25% reduction in total mortality and a 28% reduction in cardiovascular (CV) disease and diabetes mortality. Unfortunately, weight gain is the undesirable feature of several current antidiabetic treatments such as thiazolidinedione, sulphonylureas, and insulin, with an estimated 2-kg weight gain for every 1% decrease in HbA1c. Weight loss is especially challenging for individuals with T2D, who often experience a reduced response to weight-management pharmacotherapy compared with individuals without DM. The unique drug properties of GLP-1 agonists provide a safe and effective tool for both glucose control and weight loss in obese patients. Recent data among patients with T2D who were at high risk for CV events while they were taking standard therapy, those in the liraglutide group had lower rates of CV events and death from any cause than those in the placebo group. Sodium glucose co-transporter-2 (SGLT2) inhibitors, including empagliflozin, dapagliflozin and canagliflozin, are now widely approved anti-hyperglycemic therapies. Due to their unique glycosuric mechanism, SGLT2 inhibitors also reduce weight. According to the EMPA-REG OUTCOME results, SGLT2 inhibitors got prioritization in patients with T2D who have not achieved glycemic targets and who have prevalent atherosclerotic cardiovascular disease. When choosing glucose-lowering medications for overweight or obese patients with T2D, consideration of their effect on weight is essential. Whenever possible, minimize medications for comorbid conditions that are associated with weight gain.