Day 2 :
Keynote Forum
Claude K Lardinois
University of Nevada, USA
Keynote: Cardiovascular Disease (CVD) and Diabetes-Know Your Risk-Is it time for a paradigm shift
Time : 9:30-10:10
Biography:
Claude K Lardinois is an Emeritus Professor, University of Nevada School of Medicine in Reno, NV and Medical Director, American Health Care, Rocklin, CA. He has earned his Medical degree at George Washington University in Washington, DC and Internal Medicine Residency at Travis Air Force Base, Fairfield, CA. He has completed a Fellowship in Endocrinology and Metabolism with a focus on insulin research at Stanford University in Palo Alto, CA, under the mentorship of Gerald Reaven, MD. His research interests include work in nutrition, diabetes, hypertension and dyslipidemia. He has a notable interest in eradicating heart disease, the major cause of death in the US.
Abstract:
CVD is a major complication of diabetes and the leading cause of early death among people with diabetes about 65 percent of people with diabetes die from heart disease and stroke. Annually in the United States 1,000,000 people will suffer a myocardial infarction: One-third of those will occur in people who have already suffered an event. Modification of traditional risk factors, such as smoking cessation, decreasing blood pressure and lowering of cholesterol in high risk individuals has resulted in reducing CVD and stroke remarkably. However, the current standard of care using traditional modifiable risk factors alone is frequently inadequate to identify some individuals with CVD. Therefore, it is important to not rely solely on risk factor modification when assessing for CVD, but also to incorporate a disease platform. A new paradigm focusing on the disease (atherosclerosis) is necessary. Non-invasive endothelial testing [coronary calcium score (CCS), carotid intima media thickness (cIMT)], genetics assessment [Apolipoprotein E (ApoE), kinesin-like protein 6 (KIF6), 9 region p21 locus (9p21), lipoprotein (a) (LPA) and haptoglobin genotype (Hp 1-1, Hp 1-2, Hp 2-2)] and measurement of major biomarkers [F2-Isoprostanes (F2-IsoPs), high sensitivity C-reactive protein (hs-CRP), urine albumin creatinine ratio (UACR), myeloperoxidase (MPO), lipoprotein associated phospholipase A2 (Lp-PLA2), fibrinogen, and homocysteine (Hcy)] enhance the ability to identify disease (atherosclerosis) earlier. When disease is found, the causes must be identified and treated. A paradigm shift focusing on arteriology (disease platform) is mandated to reduce the high rate of recurrence of CVD and stroke.
Keynote Forum
M A Hasanat
Bangabandhu Sheikh Mujib Medical University, Bangladesh
Keynote: Gestational diabetes and postpartum persistence of glucose abnormality, ethnic variability: Bangladesh perspective
Time : 10:10-10:50
Biography:
M A Hasanat has completed his studies from Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, Bangladesh. Presently he is a Chairman of Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh. He has published about 50 original articles in reputed journals and presented papers at national and international level. He is also a Member of Editorial Board of American Research Journal of Endocrinology.
Abstract:
Variation in prevalence of gestational diabetes mellitus (GDM) among different ethnic groups imposes the need for universal screening and investigation of risk factors. According to International Diabetes Federation (IDF), South-East Asia has the highest prevalence of hyperglycemia in pregnancy (24.2%). Unlike others, an alarming frequency of GDM in Bangladeshi population has been observed recently which were as high as 36.6% and 40.9% by ‘WHO’ 1999 and ‘WHO’ 2013 diagnostic criteria respectively. Genetic predisposition may be responsible for this. We noticed higher frequency of rs7903146 polymorphism of TCF7L2 in Bangladeshi GDM mothers having relatively lower age and body mass indexes (BMI). Advanced maternal age, high BMI and family history of diabetes were found to be important risk indicators of GDM. Moreover, we observed high frequency (50%) of postpartum persistence of abnormal glucose tolerance (AGT) in women with glucose abnormality in pregnancy. AGT in early gestation, use of insulin during pregnancy, higher maternal age and BMI were predictors for it. Recently, another study found 22% persistence of AGT at postpartum in GDM (excluding DM in pregnancy, DIP). Of pregnancy outcome, premature rupture of membrane was significantly higher in GDM whereas incidence of vaginal candidiasis was higher in non GDM mothers. Neonatal hypoglycemia and hyperbilirubinemia were higher in GDM mothers though not significant. High prevalence of postpartum persistence of AGT reinstates the fact that our ethnicity as South-East Asian confers the greatest risk of diabetes mellitus (DM) among our pregnant and post-pregnant mothers which may be considered as an extrapolation of the ‘thrifty phenotype’. In conclusion, multinational broad based comparative studies are needed to explore the genetic predisposition and risk factors for GDM among the ethnic groups of different countries.
- Diabetes and Its Complications
Diabetic Market Research
Diabetes Drug Delivery in Market
Diabetes: Prevention and Management
Diabetes : Treatment and Therapy
Diabetes: Clinical Research and Case Study
Chair
Gary A Trager
American Association for Clinical Endocrinologists, USA
Co-Chair
Joseph Fomusi Ndisang
University of Saskatchewan, Canada
Session Introduction
Joseph Fomusi Ndisang
University of Saskatchewan, Canada
Title: Role of heme oxygenase in insulin signaling and glucose metabolism
Biography:
Joseph Fomusi Ndisang is an Associate Professor in the Department of Physiology of University of Saskatchewan, College of Medicine. He has completed his Postdoctoral training in Physiology at the University Of Saskatchewan, College of Medicine. He has received his PhD in Pharmacology & Toxicology from the University of Florence, Italy and received a Doctor of Pharmacy degree from University of Florence, Italy. He has got several distinguished awards and distinctions including: Associate Fellow of the Scientific Council of the International College of Angiology (2007).
Abstract:
Impaired insulin signaling and deregulated glucose metabolism are amongst the hallmarks in diabetes. Here, we report the effects of the cytoprotective enzyme, heme-oxygenase, (HO) on insulin signaling and glucose metabolism. The administration of the HO-inducer, hemin, to streptozotocin-induced diabetic animals normalized hyperglycemia and the potentiated important proteins implicated in the insulin-signal transduction pathway such as IRS-1, PI3K and GLUT4. Interestingly, the anti-diabetic effects of hemin was accompanied by enhanced levels of adiponectin, improved insulin sensitivity and reduced glucose intolerance. These were associated with the reduction of oxidative/inflammatory mediators like 8-isoprostance, nuclear-factor-kappaB, activating-protein (AP-1), AP-2 and c-Jun-NH2-terminal-kinase. Furthermore, hemin suppressed the pro-inflammatory macrophage-M1-phenotype alongside several pro-inflammatory agents, chemokines and cytokines including macrophage-inflammatory-protein-1-alpha (MIP-1α), macrophage-chemoattractant-protein-1 (MCP-1), TNF-α, IL-1β and IL-6. Conversely, hemin significantly enhanced the anti-inflammatory macrophage-M2-phenotype and IL-10. We conclude that upregulating the HO system abates hyperglycemia in diabetic animals by nullifying inflammation and oxidative stress, while concomitantly potentiating insulin signalling and glucose metabolism. Thus HO-inducers may be explored in the search for novel remedied against type-1 diabetes.
Mingxia Yuan
Capital Medical University, China
Title: A community-hospital collaborative approach for diabetes management in Beijing—Beijing Community Diabetes Study (BCDS)
Biography:
Mingxia Yuan has completed her MD in 2003 from Peking University Health Science Center. She is the Associated Professor and Vice-Director of the department of Endocrinology, Beijing Tongren Hospital, Capital Medical University. She has been serving as an Editorial Board Member of the Chinese Journal of Diabetes and the Journal of International Diabetes. She has been the principal investigator of study projects supported by including National Natural Science Foundation of China (NSFC_81370946), IDF-BRIDGES funding (ST12-024), and the Special Scientific Research on Capital Health Development (2011-2005-01, 2016-1-2057).
Abstract:
Beijing Community Diabetes Study (BCDS): This project consists of the implementation and evaluation of a community-hospital integrated management for type 2 diabetes in Beijing, China. This ongoing project is a longitudinal community-based research, with the purpose of translating standard care to the real world clinical practice to optimize control of blood glucose, blood pressure and lipids, which could be expected to reduce the risk of chronic complications in the patients with diabetes. Over 4000 subjects aged from 20 to 80 years with type 2 diabetes from 25 community health centres in five urban districts were recruited at the baseline (between August 2008 and July 2009). Management adjustment strategies on guidelines have been applied by a collaborative team consisting of 15 specialists from tertiary hospital and 120 community GPs. To ensure the integrity and quality of data collection, a supervision team consisting of four trained specialists has been checking study progress and data records in every community centre twice yearly. By analysis, a significant reduction in HbA1C was shown with the intervention. 21.0% met all the HbA1C, blood pressure, and LDL-C target values after 6 years of intervention (in June 2015), which showed continuous increase compared with that in 2013 (13.1%), in 2011 (6.7%), and the baseline (5.5%). Significant reductions of the risk in diabetic microvascular complications and cerebral vascular disease, with the trend toward CVD were demonstrated. To date, the community-based lower-cost intervention offered by a collaborative team has proved to be an effective approach, and further exploration and follow-up study will continue for the next three years.
Gazi Md Mustakim
North South University, Bangladesh
Title: Anti-hyperglycemic activity of Aegle marmelos is partly mediated by alpha amylase inhibition and retardation of glucose absorption
Biography:
Gazi Md. Mustakim is pursuing Bachelor of Pharmacy at North South University, Dhaka, Bangladesh. He is doing his research work under the supervision of Prof. Dr. J M A Hannan. He has submitted number of research works for publication in reputed journal which is under process. He is a great team leader and a friendly person to work with. He has attended many International Conferences such as IUPAC conferences. Not only he has skills in doing lab work, he also has great skills on SPSS statistical software, Microsoft office.
Abstract:
The study was designed to observe the anti-hyperglycemic effect of Agele marmelos as reported earlier in diabetic model rats. This study was carried out to explore the possible effects of A. marmelos extract on carbohydrate absorption and glucose utilization. We measured fasting blood glucose and performed glucose tolerance test to evaluate the primary anti-hyperglycemic effect, in type 2 diabetic rats. Further, we studied the plasma insulin concentration and serum glucose level. Effect of extracts on carbohydrate break down, sucrose malabsorption and gut perfusion study of the GI tract and α-amylase inhibition were assessed. Gastrointestinal motility was seen by BaSO4 milk traverse test. Treatment of extracts suppressed blood glucose elevation after oral sucrose (2.5 g/kg) administration and (1.25 g/kg) significantly improved oral glucose tolerance in type 2 diabetic rats. A. marmelos extracts showed significant changes in plasma insulin secretion. The extracts significantly reduced glucose absorption in the in situ perfused rat intestinal model at two different doses. The extract inhibited the action of α-amylase, and this study was confirmed again by the sucrose malabsorption test, where sucrose digestion was inhibited throughout the length of the GI Tract. During the chronic study, body mass of rats returned to normal and their polydipsic and polyphagic conditions were improved too. This combination of in vitro, in vivo and in situ intestinal perfusion technique confirmed the anti-hyperglycemic activity of A. marmelos and its tissue level mechanism. Additional study is required to fully demonstrate the effects of the active compounds to the precise mechanism of glucose-fiber binding capacity and glucose transporters.
Modhuswiny Mohona
North South University, Bangladesh
Title: Butea monosperma increased glucose uptake in skeletal myocytes of type 2 diabetic model mice
Biography:
M Mohona is a senior student of the Department of Pharmaceutical Sciences and is pursuing MPharm degree in Pharmacology & Clinical Pharmacy at North South University. Previously she has attended various national and international Diabetes Conferences where she presented her research work. She has a passion for further research on Diabetology.
Abstract:
Butea monosperma has previously shown to increase muscle glycogen in type 2 diabetic model mice. In this study, mechanism of anti-diabetic action of the bark was elucidated by measuring glucose uptake in skeletal myocytes of type 2 mice. Ethanol extract of B. monosperma was fed to diabetic mice at a dose of 200 mg/kg twice daily for 40 days. The skeletal muscle isolated from mice was homogenized to prepare the membrane faction. Membrane-bound GLUT transporters were quantified using mice GLUT1 and GLUT4 ELISA kits (UScn Life Science Inc. USA), Hexokinase II activity by “Hexokinase II Colorimetric Assay kit” (Sigma Aldrich, USA) and estimated Glucose-6-phosphate by colorimetric G-6-P assay kit (Abcam, USA). The glycogen synthase activity was determined following a method described by Danforth et al. (1965). In the muscle homogenate assayed Glycogen content using a colorimetric Glycogen assay kit (Abcam, USA). The extract significantly increased membrane docked GLUT1 and GLUT4 transporters by 74.50% (p<0.05) and 131.12% (p<0.01) respectively. Hexokinase II activity in skeletal myocytes was increased by 53.1% (p<0.05) whereas, Glucose-6-phosphate content was lowered (p<0.05). Glycogen synthase activity was significantly increased (p<0.01) in the presence of 10 mM G-6-P by 76.06%. However, no change was observed in the presence of 0.1mM G-6-P. Muscle glycogen content was increased by 69.34% (p<0.05). Result indicates that enhancement of glucose uptake was partly related to increased membrane docked GLUT1 and GLUT4 transporters in skeletal myocytes. The increase in glycogen content in skeletal myocytes is associated with enhanced Hexokinase II and glycogen synthase activity.
Astrid Indrafebrina Sugianto
University of Melbourne, Australia
Title: A comparison between islet and stem cell transplantation for treatment of type 1 diabetes mellitus: A systematic review
Biography:
Astrid Indrafebrina Sugianto is currently an Advanced Medical Science degree student at the University of Melbourne. She was nominated as one of the 300 young brightest scientists by Ministry of Education of UK in 2013. She was also the former Ambassador of the year for Harvard Project of International Relations in 2014 and also the only female representative of Indonesia for ASEAN Youth in 2014. She was previously involved in breast cancer stem cell research, before decided to focus on cellular based therapy research in 2015. She is interested in politics, international relations, psychology, biology and medical science.
Abstract:
Introduction: The incidence of Type 1 Diabetes Mellitus (T1DM) has been increasing rapidly worldwide, while the current standard therapy exogenous insulin supply is considered unsustainable and highly associated with poor glycemic control that may lead to a life-threatening condition. On the other hand, cellular based therapy including either islet cell or stem cell transplantation has been recently developed, making it pertinent to compare the effectiveness between the two alternative treatments. The aim of this systematic review is to compare the safety and effectiveness between islet cell transplantation and stem cell transplantation for future practice change.
Methods: Literature search using two databases, PubMed and Ovid Medline was conducted for primary studies published from January 2000 to November 2015. A quality assessment of identified studies were conducted using ARRIVE, NOS and MINORS assessment tools. The comparisons between treatments were done based on the mean values of insulin independence period and blood glycemic level of the subjects in the studies.
Results: In 15 out of 17 included studies, the average insulin-independent period in T1DM patient post-islet cell transplantation was proven to be four years longer compared to post-stem cell transplantation that could only achieve one year at most. The studies also found and support that islet cell transplantation has better blood glycemic control, observed through random blood glucose level ranges from 140 mg/dL to 200 mg/dL and c-peptide levels ranges from 0.3-4.5 ng/ml which marks the presence of insulin production. However, certain challenges e.g., donor shortage and poor engraftment hinder the widespread application. The studies also revealed that stem cell transplantation differentiated into ï¢-cell-like cells that produce insulin, glucagon and somatostatin, as well as acting in glucose stimulated manner, imitating the physiologic mechanism of ï¢-cells, this is in fact considered as a major potential for future development.
Conclusion: The current studies had proven a conclusive result in which islet transplantation has relatively higher effectiveness and better outcome compared to stem cell transplantation for treating T1DM patients.
S M Nazmul Haque
North South University, Bangladesh
Title: Antihyperglycemic activity of Catharanthus roseus leaf powder in streptozotocin-induced diabetic rats
Biography:
S.M. Nazmul Haque has currently completed his bachelor of Pharmaceutical Sciences from North South University in year 2015. He has worked in quite a few anti-diabetic research work of different plant extracts, under deliberate supervision of Dr. JMA Hannan, which are in process of publication. He was also one of the participant of 20th annual conference on Chemical Research Applied to World Needs (CHEMRAWN XX CONFERENCE).
Abstract:
Catharanthus roseus is a traditional medicinal plant used to control diabetes in various regions of the world. The aim of the study is to evaluate the possible antidiabetic effect of C. roseus leaf extract in diabetic rats. Rats were fed the extract for 4 weeks twice daily (0.5g/kg) and serum glucose, insulin, lipids, hepatic glycogen content were assayed. Plasma glucose was determined by GOD-PAP technique using glucose assay kit (Randox, UK). Blood total cholesterol levels were assayed using cholesterol quantization kit (Sigma Aldrich, USA). Blood Triglycerides were measured using colorimetric TG assay kit (Cayman Chemicals, USA). Plasma HDL levels were assayed using HDL assay kit (CrystalChem, USA). Plasma HDL levels were determined using HDL assay kit (CrystalChem, USA). Extract group showed (p<0.05) reduction in body weight, whereas, control animals showed an increase in body weight of 50.9%.In the extract group, plasma glucose level gradually decreased during experimental period (p<0.05). A significant decrease in plasma total cholesterol (p<0.05), triglycerides (p<0.05), LDL-cholesterol (p<0.05), and significant increase in HDL-cholesterol (p<0.05) in treated group was seen. This resulted in reduction of the atherogenic index. Thus our findings show that oral administration of C. roseus leaf powder produces antihyperglycemic effect, lowers both total cholesterol and triglyceride levels, and at the same time increases HDL-cholesterol in STZ-induced diabetic rats. The antihyperglycemic action of extract of C. roseus is associated with increased plasma insulin concentration and insulin sensitivity. This investigation shows the potential of C. roseus, for use as a natural oral agent, with both antihyperglycemic and hypolipidemic effects.