Day 2 :
Indian Pharmacopeia Commission, India
Time : 09:30-10:20
Prakash V Diwan has obtained his PhD from Postgraduate Institute of Medical Education and Research, Chandigarh, India. He has contributed in the areas of novel drug delivery systems and drug discovery. He has published over 200 papers in pre-reviewed journals. He has delivered guest lectures in India and abroad. He has also received many awards instituted by Indian Pharmacological Society. He has served as the Founder Director of NIPER, Hyderabad and Fellow of Royal Society of London, FRSC, London. Presently, he is working as Technical Advisor, Indian Pharmacopeia Commission, Government of India; Director of School of Pharmacy, Hyderabad and Consultant for Indian Institute of Technology, Hyderabad.
Oral insulin delivery has been a promising and interesting research area and can revolutionize treatment. Several studies have achieved positive results which includes nanotechnology. Considerable problems of developing oral insulin are because of small therapeutic index and short half-life which limits the success. Several insulin delivery systems, such as tablets, capsules, intestinal patches, hydrogels, microparticles and nanoparticles, have been explored to deliver insulin without much success. Various types of nanoparticles are currently studied for insulin delivery in diabetes treatment such as polymeric biodegradable nanoparticles, polymeric micelles, ceramic nanoparticles, liposomes and dendrimers. Exubera, as the fi rst and until now only inhaled insulin with a market approval, was not a market success due to insuffi cient uptake in the market. Th e intestinal micropatches for oral insulin delivery is well thought approach. Th e colon-specifi c drug delivery system has many advantages. Encapsulation of insulin in vitamin B12-coated dextran nanoparticles has been considered in complementing diabetes therapy by taking advantage of enhanced insulin absorption through vitamin B12 intrinsic factor receptor ligand-mediated endocytosis via intestine ileocytes. Artifi cial pancreas is the future of diabetes treatment. It is known that intestinal epithelial cells have insulin receptors on their apical surfaces. Researchers think that β-cell implants or Island of Langerhans transplants would be a more feasible and perhaps better option. Current research has been going on to deliver insulin experimentally and this has been achieved by the developing smart insulin patch. Oral version of acylated insulin analog with a half-life of ~70 hours is a great breakthrough. Th e herbal medicines are symbol of safety in contrast to synthetic drugs. Th e life style is becoming techno savvy and we are moving away from nature. Th e 80% of world population is using herbal medicines. Gymnema sylvestre also increases the amount of insulin in the body and increase the growth of β-cells in pancreas and many more in armamentarium of Indian herbal wealth. Most of the developments of these companies have failed in phase II clinical studies, showing insufficient metabolic control in patients with diabetes. However, researchers are concerned that oral insulin could raise the risk of certain types of cancer. Addressing these issues successfully will create a new paradigm in diabetes treatment. Future advance in drug delivery could still make it a reality.
DMU University, UK
Keynote: 6-weekes moderate-intensity combined aerobic and resistance exercise program could be anti-inflammatory treatment and delaying the onset of diabetes for subjects at risk
Time : 10:20 - 11:10
Bandar Manawer al Harbi has completed his Master of Science with Merit Pharmaceutical Quality by Design. Currently he is the Researcher in diabetes at DMU University, Pharmacy School and working as an Assistant Director of Pharmacy for Material Management Prince Sultan Military Medical City.
Introduction: Pre-diabetes describes a condition whereby an individual’s level of blood glucose is above normal level, though not high enough to warrant them a T2D diagnosis. Th e condition is classifi ed into two categories; impaired glucose tolerance (IGT) where blood glucose levels are above the normal 2 hours aft er glucose loading in the oral glucose tolerance test but not so high to warrant the classifi cation as diabetes. Th e other is impaired fasting glucose (IFG) where blood glucose have risen to a fasting state but yet again, not so high to warrant the classifi cation as diabetes. Physical exercise improves BG homeostasis but the extent to which exercise is eff ective strategy as primary prevention mechanism for people whom at risk to develop diabetes is not fully understood.
Purpose: To examine the eff ects of 6-weekes moderate-intensity combined aerobic and resistance exercise program in preventing or delaying the onset of diabetes for subjects at risk compared to sedentary non-diabetic individuals.
Methods: 20 subjects of a sedentary lifestyle, diagnosed with either pre-diabetes or at risk to developed T2D (PRE-D) and 5 Subjects were sedentary healthy individuals (ND) met the inclusion criteria. Both PRE-D and ND have been asked to complete 6-weeks of moderate-intensity combined aerobic and resistance exercise for 60 minutes on two days/week. Each exercise session consists of a combined exercise protocol of 30 minutes of resistance exercise (3 sets of 10 repetitions) followed by 20 min cycling. The primary outcome is to concentrate on metabolic results, such as improved HbA1c, blood pressure, heart rate, 1-repition max, lipid profile (reduction in total cholesterol, low density lipoproteins, triglycerides or increase high density lipoproteins) and improvements in insulin sensitivity determined by responses to oral glucose tolerance tests on independent days.
Results: There were significant reduction (p=0.00) on the HbA1c after applying of 6 weeks’ combination exercise intervention in both groups comparing to baseline. OGTT indicated significant differences between preexercise and post 12th exercise session in both groups with p=0.01. BG concentrations were reduced post each exercise session and was significant Post-EX S12 comparing PRE-EX to P=0.00 and P=0.09 in PRE-D and ND, respectively. A significant reduction in TC (P=0.04) and LDL (P=0.02) in PRE-D only. SBP drops from 127.3±13.1 to 119.6±8.4 mmHg with P=0.04 in PRE-D while in ND was not significant. HR was significantly reduced (P=0.01) and goes from 73.5±10.3 to 70.3±12.1 in PRE-D and was signifi cantly reduced (P=0.03). A significant improvement in interleukin 6, CRP and adiponectin have been achieved with P=0.00 in PRE-D and P=0.03 in ND group.1RM improved significant in back (P=0.04) and triceps (P=0.04) in PRE-D, while in ND group the significant improvement was in squat (P=0.02) and back (P=0.02).
Conclusion: A combination exercise programs, which involves both RE, and AE performed at moderate intensity (50-60% of 1RM) over 6-weeks period can be feasible and economical prevention strategies to minimize the risk factors for T2D in pre-diabetes subjects.