17^th Global Diabetes Conference & Nursing Care March 8-9, 2018 | Paris, France

Biography:

Bernadette Dian Novita is currently a Medical Doctor and Lecturer in Widya Mandala Catholic University Surabaya Faculty of Medicine. Her major is pharmacology and therapy, focusing in diabetes mellitus, infection and immunology. She has completed her PhD from Airlangga University Faculty of Medicine. She has got several national and international publications in diabetes mellitus area.

Abstract:

Metformin (MET) has possibilities of utilizing as a combination drug with existing antibiotics for TB therapy and controlling the growth of drug-resistant Mycobacterium tuberculosis (M. tuberculosis) strains via production of mitochondrial reactive oxygen species and facilitates phagosome-lysosome fusion. MET that is given to type-2 DM newly TB co-infection patients were improved the SOD level and inhibited of NF-ĸβ activation. Th e clinical effect, especially smear reversion, during metformin applied with anti-tuberculosis and insulin in patients with type-2 DM newly TB co-infection were remain unknown and this result contributes much to our understanding the use of MET in type-2 DM-TB co-infection management. An observational clinical study was done in DM newly TB co-infection outpatients at Surabaya Paru Hospital. We evaluated MET accompanying therapy with gold standard therapy of DM-TB co-infection, insulin and TB treatment regimens. MET therapy was given for at least 2 months and we compared to comparison group, whom were given insulin and TB treatment regimens. The AFB smear was measured for two purposed: (1) For diagnostic, three times measurements before therapy and (2) For evaluation, two times measurement. From 42 participants in this study, 22 participants of observation group that received additional MET therapy, 100% had AFB smear reversion conversion aft er anti tuberculosis intensive therapy. Whereas 25% of 20 participants of comparison group did not undergo reversion inserts AFB smear and needed one-month intermittent therapy. AFB smear reversion difference test using Fisher’s exact test showed results of different test p=0.046 (p<0.005), which means that there is a significantly difference of smear conversion between the observation group and the comparison group. Moreover for mechanism purposes, microtubule-associated protein1 light chain 3B (MAP1LC3B), superoxide dismutase (SOD), interferon (IFN)-γ and interleukin (IL)-10 levels were measured and also increased after MET therapy during intensive phase of anti TB and insulin therapy. Thus we concluded that MET use DM-TB co-infection increases smear reversion. Metformin has the potential of being an additive combination therapy to enhance the eff ect of anti TB bactericidal on DM infected patients. Metformin enhances the effects of anti TB and insulin therapy in increasing the smear reversion by increasing levels of microtubule-associated protein1 light chain 3B (MAP1LC3B), superoxide dismutase (SOD), interferon (IFN)-γ and interleukin (IL)-10 levels. In addition, metformin therapy use during intensive phase of TB treatment regimens and insulin did not result in elevated lactate levels and also MALA, so it concluded that metformin therapy is relatively safe for DM TB co-infection patients.

Biography:

Daniel Martin Arsanios is a Doctor at Sabana University in Colombia. He has experience in molecular biology and in conjunction with issues of sepsis and sought to go deeper into issues related to the development and complications of microvasculature in sepsis.

Abstract:

Sepsis is defined as deleterious response of host towards a pathogen, in which the number of physiopathological phenomenon implied lead to cell dysfunction, multi-organ failure and death. In this unregulated response, hormones change its functions and metabolism. One example is insulin, a peptide hormone which is not only implied on the glucose’s homeostasis and growth pathways but also function as a mediator of inflammatory, hemodynamic and micro-vascular processes involving sepsis. Insulin inhibits the production and secretion of substances implied in systemic inflammatory response syndrome like tumor necrosis factor, reactive oxygen species and nuclear factor-kB (NF-kB). Also, it is able to activate protective molecules such as Janus kinase by boosting a counter-regulation mechanism to the damage induced by NF-kB and to the phosphorylation of pathways related to mitogen-activated protein kinases, inhibiting pro-inflammatory proteins (ERK, P38) involved in cell damage, by activation of P21-RAS. Evidence supports the contribution of insulin resistance to the inflammatory phenotype that is similar in obesity microvasculature. This also leads to endothelial cell dysfunction, manifested as an impaired capacity of microvasculature to relax in response to endothelium-dependent vasodilators, favoring the binding of both leukocytes and platelets to the vascular wall. Insulin administration can attenuate this response as well as suppress genes commanding inflammatory cytokines. Based on its anti-inflammatory, hemodynamic, hormonal and regulating mechanisms of fatty acids, carbohydrates and proteins, attempts have been made to support the use of insulin during sepsis and septic shock in practice. On one side, there is evidence of mortality reduction rate of up to 3% in the ICU patient after its use greater than 28 days additionally showed a reduction in morbidity by decreasing renal injury until 8.9%, mechanical ventilation and ICU stay (p=0.05). It is important to know all the possible pathways where the insulin works to improve the utility in septic patient.

Biography:

Bushra Yunis is a Clinical Nurse Practitioner (CNP) Diabetic Nurse. She has worked as Director of Basics in Diabetes for Nurses Program in Rambam Hospital. She has completed her Master’s degree in Nursing, with specialty in Emergency Medicine and Diabetes

Abstract:

Background & Aim: Diabetes is one of the most common chronic diseases. Recent surveys shows increase in the prevalence of diabetes in the Arab population in Israel. European studies show the contribution of the diabetic clinical nurse practitioner (CNP) in improving the glucose outcome measures. Recently, the nursing administration organization in Israel recognized the role of CNP. This gives the nurse authorization to treat diabetes, including diagnosis, regulation and balance of the disease, counseling for patients and teams, prescribing prescriptions and more. The primary target is to examine the effectiveness of intervention model of CNP in primary care physician’s treatment of diabetic patients in the Arab sector. The secondary targets are improving the glucose outcome measures of diabetic patients in the Arab sector by CNP consulting with the physician and the nurse in the clinic and to improve the patient’s adherence to treatment.

Methods: The methods are: 1) Selection of two clinics from the Arab sector at the northern district, 2) Focusing on unbalanced patients with HbA1c>9%, 3) Discussion of 5 cases at each advisory meeting between CNP and primary physician and 4) Involving the nurse in the treatment plan. Arranged meeting with the primary physician and a weekly meeting with the physician. The physician fully cooperated. Both clinics had about 100 unbalanced patients. During the year, 22 meetings were held with staff of the chosen clinics.

Results: Improvement in glucose outcome measures with HbA1c>9%. In one clinic: Improvement from 14.3% to 11.9%, decrease of 17% and in the second clinic: 23.5% to 18.5% decrease of 21% in HbA1c>9%. (One of the physicians have joined the class on "Treatment of diabetes").

Conclusion: To extended this program to additional areas in accordance with the worsening level of glucose outcome measures. Build a direct computerized consulting program between CNP and physicians.

Biography:

Suhad Bahijri has obtained her BSc in 1975 and her PhD in Clinical Biochemistry in 1979, both from The University College of Wales, Aberystwyth, UK. She then joined the Faculty of Medicine at King Abdulaziz University as an Assisstant Professor. Her studies helped to establish standards for infants formulas for the Saudi market. She also established Food, Nutrition, and Lifestyle Research Unit at King Fahad Medical Research Center, establishing a possible link with excessive fluoride intake and the beneficial effect of chromium on glucose tolerance and lipid profile in Saudi individuals. In 2010, she founded the Saudi Diabetes Research Group (SDRG).

Abstract:

Most type-2 diabetes (T2DM) Saudi patients remain uncontrolled, thus increasing their risk of developing cardiovascular disease (CVD). We aimed to investigate relationship between known factors associated with increased CVD risk, such as glycaemic control, components of metabolic syndrome (MS) and novel possible predictors of CVD risk namely: Serum levels of γ-glutamyl transferase (GGT) and C-reactive protein (CRP) in Saudi T2DM patients. 71 men and 82 women were recruited for the study. Anthropometric measurements and blood pressure (BP) were taken. Treatment plan was recorded. Fasting blood samples were obtained to measure glucose, glycated hemoglobin (HbA1c), lipids profile, highly sensitive (hs)-CRP and GGT. Higher mean GGT was associated with poor glycemic control, dyslipidemia, hypertension and abdominal obesity. GGT correlated significantly (P<0.05) directly with triglycerides in men (r=0.401) and Diastolic BP (r=0.279 for men, r= 0.194, for women), but inversely with high density lipoprotein-cholesterol (r=-0.298 for men, r=-0.171 for women). hs-CRP correlated with waist circumference (P<0.05, r=0.312, for men, r=0.305, for women), with a higher mean being found in men with poor glycemic control (P=0.015), hypertensive women (P=0.030) and abdominally obese persons (P<0.05). Therefore, it was concluded that since high levels of GGT and hs-CRP are associated with components of MS and poor glycaemic control, indicating increased cardiovascular risk, they should be included in routine monitoring of type-2 diabetic patients as independent risk predictors of CVD risk.

Biography:

Abdekrim Berroukche is currently a Lecturer and Teacher-Researcher, Biology Department, Faculty of Science, University of Saida, Algeria. He has received his PhD in Cell Biology and Nutrition (with Oncology option) from University of Sidi-Bel-Abbes, Algeria. He is Member of Editorial Board of two scientific reviews and is a Peer Reviewer in several journals. He has 32 publications: 30 journal articles and 2 books. He is the Head of research team affiliated to Laboratory of Water Resources and Environment, Biology Department, Faculty of Science, University of Saida, Algeria.

Abstract:

Background: Uncontrolled and excessive uses of insecticides, in agriculture, will expose the human and animal health to a high risk of chemical toxicity. Cypermethrin (CYP), as pesticide, is widely handled in tomato growing fields in Algeria. In addition to brain and lung tissue damage, CYP induced metabolic disorders. Medicinal plants widely used, as folk remedies, by rural population. This study aimed to compare both medicinal plant and CYP effects on blood glucose level in rats.

Materials & Methods: Experiments conducted in 30 days, on 70 rats, divided into seven groups: A (controls), B (CYP at 20 mg/kg~<1/10 DL50), C (Artemisia herba alba), D (Myrtus communis), E (Eucalyptus globulus), F (Cinnamomum verum), G (Ocimum sanctum). CYP and aqueous plant extracts (as hot decoction at 50 g/L) were orally administered to animals.

Results: A significant difference in body weight gain was reported (respectively, 54.67, 15, 39.67, 12.65, 8.34, 39.63 and 4.66 g). No significant different results found about blood glucose levels and their mean values were respectively, 0.82±0.01, 0.94±0.03, 1.51±0.17, 0.73±0.08, 0.72±0.05, 0.71±0.03 and 0.81±0.02 g/L. Furthermore, serum levels of renal markers showed slight variation such as urea (respectively, 0.66±0.02, 0.61±0.05, 0.83±0.03, 0.47±0.13, 0.52±0.05, 0.72±0.01 and 0.44 ± 0.2 g/L) and creatinine (respectively 7.4±0.2, 8.17±0.14, 9.6±1.25, 6.56±1.38, 7.13±0.07, 7.63±0.64 and 8.23±0.08 mg/L).

Conclusion: Medicinal plants, used in this study, showed more or less significant hypoglycemic effects in contrast to CYP slightly hyperglycemic. Other studies are expected to consolidate this thesis.

Biography:

Sako Mirzaie has PhD in biochemistry and a faculty member of Azad University of Sanandaj. He has more than 24 papers in international journals. He is expert in molecular modeling, protein engineering and enzyme kinetic assay. In his new research, he is looking for the new formulation for increased stability of insulin in certain intelligent implant.

Abstract:

Statement of the Problem: One of the most worldwide health problems, which is a disorder in glucose metabolism and causes diverse dangerous symptoms, is diabetes mellitus (DM). Two types, diabetes mellitus type 1 (T1DM) and diabetes mellitus type 2 (T2DM) are the major forms of DM. In 2013, it has been estimated that 382 million people had DM. Among them, about 90% cases were T2 DM.

Methodology & Theoretical Orientation: In the current study, at first, interventional and experimental studies on 45 patients with T2DM were occupied and the effects of restricted diet, metformin and insulin in the absence or presence of vitamin D were evaluated on certain blood biochemical parameters. Also, molecular dynamics (MD), molecular docking and MM/PBSA were employed to analyze the flexibility of vitamin D receptor (VDR), in free or ligand bound form, during 50 ns.

Findings: Experimental data showed that the combination of metformin/ vitamin D or insulin/ vitamin D treatments can decrease the fasting blood glucose. Vitamin D alone or in combination with insulin or metformin decreases the LDL and cholesterol of patient’s serums. Vitamin D along with insulin decreases the insulin resistance and increases the insulin sensitivity in patients with T2DM. Glut 4, which is not detected in the lymphocyte of healthy people or patients with T1DM, was found in the patient’s peripheral lymphocytes. The MD results showed that in the presence of metformin, the flexibility of helix 12 residues from vitamin D bound VDR were decreased. Also, metformin decreased the radius of gyration of agonist bound VDR. However, metformin has no effect on the binding free energy between VDR and vitamin D.

Conclusion & Significance: Our data showed that metformin, in the presence of vitamin D could stimulate the interaction between VDR and co-activator receptor.

Biography:

Chaaba Raja has completed her PhD in Biological Engineering in 2006 and is interested in research about lipids, diabetes and cardiovascular disease. She is a Member of research laboratory “Nutrition-Functional Foods and Vascular Health”, Faculty of Medicine, Monastir, Tunisia. She is an Assistant Professor in Superior Institute of Applied Sciences and Technology, Mahdia, Tunisia.

Abstract:

Diabetes constitutes a real problem of public health. Both genetic and environmental factors are involved in the etiology of diabetes. Several genes have been associated with increased risk of diabetes such as those encoding proteins involved in the mechanisms of desaturation and elongation of fatty acids. To search for a possible association between these rs174556 of the FADS1, rs174617C>T FADS2 and rs3756963C>T ELOVL2 genes polymorphisms and diabetes in Tunisian population, a case/control study was conducted. The genotyping was performed by PCR-RFLP method in 130 diabetic patients and 186 normal subjects. Obtained results showed that the polymorphisms of the genes FADS1, FADS2 and ELOVL2 are diabetes predisposing genes. An association was found between FADS1, FADS2 and ELOVL2 polymorphisms and severity of the diabetes. Individuals who carried two risk genotypes and three risk genotypes had a higher risk of diabetes than those who did not carry any risk genotypes of the three genes. To search a correlation between the three polymorphisms and the fatty acid profile, no significant difference was found for the different fatty acids analyzed between diabetic patients and controls. On the other hand, fatty acids [vaccenic, linoleic, linolenic, Dihomo-γ-linolenic (DGLA), Docosatetraenoic, Eicosapentaenoic (EPA), Clupanodonic (DPA) and Docosahexaenoic (DHA)] are significantly correlated with diabetes. An association was found between the three polymorphisms and fatty acids studied (p<0.05). In conclusion, further studies of the relationship between the polymorphisms of these three genes and the fatty acid profile are warranted, for better understanding their roles in diabetes.