9^th Diabetologists Conference June 06-08, 2016 Dallas, Texas ,USA

Sunaina Gautam has completed her PhD from Department of Zoology, University of Lucknow, India. Presently, she has joined as a Postdoctoral fellow in the Department of Biochemistry, King’s George Medical University Lucknow, India under the D.S. Kothari Post doc fellowship scheme. She has published more than 10 papers in national and international reputed journals. She has won few prizes including Young Scientist Award in conference organized by the Zoological Society of India. She has co-supervised the dissertation work of MSc students and was also involved in various conferences and workshops organized by her laboratory.

Abstract Type II diabetes mellitus (T2DM) is now considered to be a serious disease that is always associated with long-term and life-threatening complications, attributed deaths and economic burden to nations. Several Single nucleotide polymorphisms (SNPs) in CD36 gene have been found to be associated with metabolic syndrome and HDL metabolism, both predictors of the risk of heart disease and T2DM. We studied eleven SNPs in entire CD36 gene and their association with 100 each of control subjects and T2DM. The haplotypic analysis of few significant SNPs was carried out in individuals from families with diabetic history in order to evaluate its utility in disease prediction. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) was used for genotyping. Ten families with a family history of diabetes were identified and blood samples were collected from as many family members as possible. Genotyping of three SNPs viz. rs1761667 (G>A) in exon 1 A, rs3211938 (T>G) in exon 10 and rs3212018 (16 bp del) in exon 14 was performed in all samples. In our study on North Indian population SNP G>A (rs1761667) genotypes showed a highly significant association (P<0.001) and 1264T>G (rs3211938) showed mild significant for T2DM (P=0.045). Moreover, individuals having a ‘GATTC1’ haplotype might be at risk of developing T2DM (P<0.001) and therefore might be susceptible to related complications. In addition of it, ‘A’ ‘G’ and ‘G’ alleles of SNPs rs1761667 (G>A), rs3211938 (T>G) and rs1984112 (T>G) respectively tend to have increased BMI. Such studies may be helpful for disease prediction in individuals at risk of T2DM and could be used as a genetic marker.

Julie Walker has completed her Bachelor of Science in Nursing from the University of North Dakota, Grand Forks and is a Member of Sigma Theta Tau International Honor Society of Nursing. She has more than 15 years of experience in the medical device and pharmaceutical industries as an Educator and a Marketer; during which she has more than 50 publications. Currently, she is the Manager of Market Development for ARKRAY USA; a leader in the diabetes care market. She is also on the Executive Council at the Minnesota based American Diabetes Association and is Co-Captain for the ARKRAY USA Step Out and Walk team.

Abstract Background: Lancets are a necessary tool used in the blood glucose testing and management of diabetes. In order for a lancet to assist in providing a sufficient capillary blood drop for testing, it needs to be easy for the healthcare professional to use. Purpose: The objective of this study was to compare the Ease of Use of the Assure® Lance Plus 25 gauge lancet to the Haemolance® Plus 25 gauge lancet by healthcare professionals. Methods: A total of 8 laboratory professionals were asked to fire three Assure® Lance Plus25 gauge lancets and three Haemolance® Plus 25 gauge lancets into a stack of laboratory pads. Each laboratory professional was then asked to compare the Assure® Lance Plus lancet to the Haemolance® Plus lancet by the following rating scale: Less Easy to Use=0, Same=1, or More Easy to Use=2. Results: Six of the eight participants rated the Assure® Lance Plus 25 gauge lancet More Easy to Use than the Haemolance® Plus 25 gauge lancet. One participant scored the lancets as the same and one subject rated the Assure® Lance Plus 25 gauge lancet less easy to use. Conclusion: The Assure® Lance Plus 25 gauge lancet was rated more easy to use than the Haemolance® Plus 25 gauge lancet with an average ease of use rating of 1.6.

Harini A Chakkera has completed her MD in India, Internal Medicine Residency training at Hennepin County Medical Center, Minneapolis, MN and subsequently General Nephrology and Transplant Nephrology Fellowship at UCSF, San Francisco, CA. During her Fellowship she has completed her MPH at UC Berkley. She is an Associate Professor of Medicine at Mayo Clinic and practicing Transplant Nephrologist. She is the Medical Director of the Pancreas Transplant Program at Mayo Clinic in Arizona. She is actively involved in epidemiology research, with her expertise being new onset diabetes after transplantation. She has published over 50 peer reviewed manuscripts. She is an active Member and serves on various committees of the American Society of Nephrology and American Society of Transplantation.

Abstract While simultaneous pancreas kidney transplant (SPKTx) is a therapeutic option for patients with type 1 diabetes (T1DM) and renal failure, few centers offer SPKTx to “select” non-T1DM patients. To address concerns that existing insulin resistance may limit the benefits of the pancreas allograft among non-T1DM we compared several indices of glucose homeostasis, in “select”, non-T1DM and T1DM patients who received SPKTx. Criteria for “select” non-T1DM included: Positive C-peptide, BMI <30 kg/m2, treatment with oral agents before insulin initiation and insulin at <1 unit/kg/day. We compared several indices of glucose homeostasis within 1 year post-SPKTx among seven “select” patients with non-T1DM and nine patients with T1DM with similar age, BMI and immunosuppression. Measurements of insulin resistance included: Homeostatic model, insulin sensitivity index and insulin glucose ratio; insulin secretion measures included: Corrected insulin response. We found non-T1DM had similar pre-transplant metabolic (fasting glucose, HbA1C, blood pressure and lipid) parameters to the T1DM cohort. There were no significant differences in the various measures of insulin resistance and secretion between T1DM and “select” non-T1DM patients. In conclusion our results suggest SPKTx should be considered in the therapeutic armamentarium among carefully select non-T1DM with features of minimal insulin resistance; however, a larger cohort with longer follow-up is needed to confirm our results.

F F Ruchita is a senior student in the Department of Pharmaceutical Sciences pursuing BPharm (Professionals) degree at North South University. She has attended national and international conferences where she acknowledged many important things about her research work, which she is doing currently at Pharmacology Lab of North South University. She has interest in Pharmacology and wants to obtain her further dergees on that.

Abstract Tinospora cordifolia is traditionally used as tonic and a remedy for diabetes. It was previously shown to have hypoglycemic effects in rats.The aim of this study is to investigate the effects of ethanolic extract of T. cordifolia on serum glucose, lipid profiles and hepatic glycogen content in type 2 diabetic rats.Extract of the T. cordifolia leaves was prepared by 80% ethanol. Hypoglycemic effects were evaluated in type 2 rats at fasting and postprandial states at different time points (0, 30, 60 and 120 min) by measuring serum glucose and insulin. Extract (500 mg/kg body wt) was administered orally to type 2 diabetic rats for 28 days and at the end of the experiment, serum glucose, serum insulin (using ELISA Rat insulin kit); lipid profiles (TG, cholesterol and HDL) were measured using commercial assay kits (CrystalChem, USA). Hepatic glycogen content was measured using Anthrone method.The extract reduced glucose level at 60 min (p<0.05) after glucose load without increase in serum insulin levels in acute study. In 28 days study, a significant reduction in blood glucose (p<0.01), Triglycerides (p<0.05) and total cholesterol (p<0.05), and significant increased (p<0.01) in HDL and hepatic glycogen content (p<0.01) were observed. No significant change was found in LDL level. It considerable increased body weight (p< 0.05) in the chronic study. Tinospora cordifolia shows hypoglycemic effects in diabetic rats without significant change in insulin level. Isolation of pure compounds from T. cordifolia can be a novel promising drug in the treatment of diabetes.

Sunita Neupane has completed her Bachelor level in two programs (Sociology and Paramedical Sciences) from Tribhuvan University and is running a Post-graduate program, Master in Public Administration from Kritipur, Kathmandu. She is the Lab Technologist of Universal College of Medical Sciences. She has published her papers in magazines, news paper, etc. She has achieved numerous awards by the Kathmandu Chabahil Lions Club, Nepal Association for Medical Laboratory Sciences, National Conference, Nepal Medical Laboratory Students Society, Nepal Cancer Support Group and many more.

Abstract To examine a linear association between serum uric acid concentration, microalbuminuria as well as age, age at onset, duration of DM, blood pressure (BP), body mass index (BMI), and HbA1c in T2DM patients. This cross sectional study included 50 Type 2 diabetes mellitus patients. Type 2 diabetes mellitus was diagnosed according to the WHO criteria. Nephropathy was graded as follows: normoalbuminuria, urinary albumin excretion less than 30 mg/L; microalbuminuria, 30 to 300 mg/L; or macroalbuminuria, more than 300 mg/L. Serum uric acid concentrations were measured by enzymatic method (uricase-peroxidase). The HbA1c was measured using the principle of dry chemistry. Similarly urinary albumin excretion was measured with an immunoturbidometric assay. Mean serum uric acid concentration was 6.75±1.36mg/dl. Serum uric acid concentration was higher in patients with microalbuminuria (7.54 ± 1.39 mg/dl) than in patients with normoalbuminuria (6.44±1.23 mg/dl, p=0.009). In addition Serum uric acid concentration was higher (p=0.002) in patients with hypertension (7.26±1.48 mg/dl), than in patients without (6.10±0.82 mg/dl). Serum uric acid concentration correlated positively with urinary albumin excretion (r=0.323, p<0.05), age (r=0.337, p<0.05), age at onset (r=0.341, p<0.05), and duration of DM (r=0.312, p<0.05). Multiple regression analysis demonstrated that Serum uric acid concentration (β = 0.293, p<0.0001), duration of DM (β=0.261, p<0.0001), HbA1c (β=0.173, p<0.005), and systolic blood pressure (β=0.268, p<0.005) were independent determinants of urinary albumin excretion. The findings extend the knowledge on the relationship between uric acid concentrations, microalbumin, HbA1c and associated confounding variables among the researchers which highlight the importance of screening for microalbuminuria to prevent renal impairment and measuring HbA1c level on a regular basis for good glycemic control are important in diabetic patients.

Zahra Banazadeh is currently working as Internist at University of Medical Sciences, Iran. She specially works in internal Medicine. She served for about 14 months in school health clinic in the Olympic Village of Tehran. She is having certification in ICDL.

Abstract Background: The aim of this study was to measure the body composition in adults with newly diagnosed type 2 diabetes mellitus and to explore the effect of metformin therapy on the various components of body composition, insulin sensitivity and glucose homeostasis. Methods: This was an observational study consisted of 51 newly diagnosed people with type 2 diabetes on 1000 mg metformin twice daily for 6 months. The body composition of each subject was measured by dual energy X-ray absorptiometry at enrollment and 24 weeks after metformin mono-therapy. Sarcopenia was defined and compared based on the ratio of appendicular skeletal muscle and height squared, skeletal muscle index and residual methods. Homeostasis model assessment-insulin resistance and Quantitative Insulin Sensitivity Check Index were used for estimating insulin sensitivity. The level of physical activity was assessed using self-administered International physical Activity questionnaire. Results: Forty one subjects (80.4%) completed the study. The mean age of the participants was 52.67±10.43 years. Metformin treatment was associated with a significant decrease in total fat mass (-1.6 kg, P=0.000). By week 24, the lean to fat ratio increased (P=0.04) with men showing greater significant changes. Twenty percent of the female participants were detected to have sarcopenia. In addition, there was a significant improvement of glucose homeostasis and insulin sensitivity. Conclusions: Metformin therapy results in significant improvement in body composition and insulin sensitivity of adults with newly diagnosed type 2 diabetes. Furthermore, sarcopenia begins in women with diabetes much earlier than expected as an age related phenomenon.

Abstract Installation of Mobile Phone Base Stations in residential areas has initiated public debate about possible adverse effects on human health. This study aimed to determine the association of exposure to Radio Frequency Electromagnetic Field Radiation (RF-EMFR) generated by Mobile Phone Base Stations with glycated hemoglobin (HbA1c) and occurrence of type 2 diabetes mellitus. For this study, two different elementary schools (school 1 and school 2) were selected. We recruited 159 students in total; 96 male students from school 1, with age range 12-16 years and 63 male students with age range 12-17 years from school 2. Mobile phone base stations with towers existed about 200 meters away from the school buildings. RF-EMFR was measured inside both schools. In school 1, RF-EMFR 9.601 nW/cm2 at frequency of 925 MHz and students had been exposed to RF-EMFR for duration of 6 hours daily, 5 days in a week. In school 2, RF-EMFR 1.909 nW/cm2 at frequency of 925 MHz and students had been exposed for 6 hours daily, 5 days in a week. 5-6 ml blood was collected from all the students and HbA1c was measured. The mean HbA1c for the students who were exposed to high RF-EMFR was significantly higher (5.44±0.22) than the mean HbA1c for the students who were exposed to low RF-EMFR (5.32±0.34) (p=0.007). Moreover, students who were exposed to high RF-EMFR generated by MPBS had a significantly higher occurrence of type 2 diabetes mellitus [P=0.0001] relative to their counterparts who were exposed to low RF-EMFR. It is concluded that exposure to high RF-EMFR generated by MPBS increase HbA1c and occurrence of type 2 diabetes mellitus among school aged adolescents.