25^th International Conference on Human Metabolic Health- Diabetes, Obesity & Metabolism March 21-22, 2019 Carlton Palace Hotel | Dubai | UAE

Biography:

Abstract:

Biography:

Archana Arora is a Registered Dietitian and has been practicing for more than 20 years in the fi tness, healthcare, wellness and catering industries. She has completed her Masters in Food and Nutrition in 1995 followed by an internship at the All India Institute of Medical Sciences, New Delhi. Currently, she is working as a Senior Dietitian and Health Coach at NU Foods, Dubai.

Abstract:

Way of life is central to human wellbeing, from what we eat, how much we move, what we think, what chemicals we are exposed to, how we deal with our emotions and the quality of sleep and the list goes on. Epigenetics (a change in our genetic activity without changing our genetic code) shows that genetics is only 30% of the health equation, with lifestyle choices being 70%. But do we realize it is the wrong lifestyle choices we make, that prepare our body for disease and lead to death. Self-analyzation, willingness to change, continuous wellness journey with trustworthy professional, self-effi cacy evolution (people’s belief that they have the ability to perform particular behaviors) and perseverance can be the most obvious drivers of signifi cant health evolution in your life. With practice, we can enhance our wellbeing and achieve a state of balance and contentment. Lifestyle choices that we make are the basis of our well-being and enhanced quality of life.

Biography:

Ragdah A Hamid has completed her Bachelor’s degree in Nursing from The University of Jordan and her Post Graduation Diploma in Diabetes Primary Care from St. Geroge University School of Medicine. She is the Diabetes Nurse Educator in King Saud Medical City, Riyadh.

Abstract:

Introduction: Th e Diabetes Nurse Educator (CDE) role in King Saud Medical City is a new approach to improving the quality of staff competencies in the care of patients with diabetes. Th e Diabetes Nurse Educator is an advanced nursing clinician with a focused expert practice area who works to improve the care at the bedside by combining roles as clinician, consultant, researcher, educator, and manager. Th e Diabetes Nurse Educator has specific responsibilities in serving as an expert in the specialty, ensuring the incorporation of evidence-based practices, promoting research, evaluating the staff nurses’ practice, providing continuous learning opportunities, and promoting critical thinking and problem solving. Location/Setting: King Saud Medical City-Riyadh, Endocrinology Department – Diabetes Division Outpatient Clinic and In-patient Units- General Hospital Objective: Th e goal of implementing the Diabetes Nurse Educator role at King Saud Medical City (KSMC) was to improve the quality, safety, eff ectiveness, and effi ciency of staff nurses caring for patients with diabetes. Activities: Th e Diabetes Nurse Educator activities include: Th e Development and Implementation of Educational Programs for Staff Nurses, Participating in Staff General Nursing Orientation Program (GNO),Organizing Hospital Continuous Nurse Education (HCNE) and Unit Continuous Nurse Education (UCNE) activities in clinical areas Developing Multidisciplinary Educational Programs through the year with other Health Care Professionals, Leading Nursing Grand Rounds and In-service Education, Provide Clinical Resource and Consultation to Staff Nurses in Collaboration with the Endocrine Team, Developing and Implementing Written Protocols and Order Sets in Coordination with Endocrine Team, Working within the community to promote health care including education and training for Community to Support Workers Conclusion: Th e CDE plays an integral role in the prevention, diagnosis and adequate management of diabetes. Th is specialist role can increase skills, knowledge and confidence, as well as support and empower staff nurses who deal with diabetic patients and help to reduce the chances of developing further complications of the disease.

Biography:

Maha Mohammed Arnous has completed his MD degree from School of Medicine in King Fahad Medical City in Riyadh, Saudi Arabia. She is the Senior Resident of Community and Family Medicine at Security Forced Hospital. She is very active in clinical research of diabetes care and prevention.

Abstract:

Background: Many studies have provided evidence for an increased risk of atrial fi brillation among diabetic patients as compared to the non-diabetic population. It is also well known that diabetes predisposes a person to an increased risk of diabetic nephropathy. A few reviews and studies have hinted towards an increased risk of atrial fi brillation among diabetic nephropathy patients. Aim: To conduct a meta-analysis to explore if there is an association between diabetic nephropathy and atrial fi brillation. Methods: Th e available literature was searched for relevant studies from the period of January 1995 to October 2018. Th e following quality assessment criterion were considered for study shortlisting: Clearly defi ned comparison groups, same outcome measured in both comparison groups, known confounders addressed and a suffi ciently long and complete (more than 80%) follow-up of patients. Two independent reviewers searched the databases, formed their search strategies and fi nalized the studies. Data was analyzed to obtain a summary odds ratio along with a forest plot by Cochrane’s RevMan 5.3. Results: Only four studies were found to meet the inclusion criterion for this meta-analysis (total number of study participants: 307330, diabetic nephropathy patients: 22855). Of these, two were retrospective cross-sectional studies, one was a prospective cohort study and one was a case control study. Th ree studies had provided the odds ratio as the measure of eff ect (two retrospective cross-sectional studies and one case control study), with the one cohort study reporting the hazards ratio as the measure of eff ect. Th erefore, the meta-analysis was done excluding the cohort study. Th e summary odds ratio in the present study was 1.32 (0.80-2.18), which was not statistically signifi cant. Due to large heterogeneity among the included studies and their small sample sizes, it was found that the summary estimate shift ed towards the null value. Conclusion: Th e present meta-analysis found no signifi cant association between atrial fi brillation and diabetic nephropathy. However more studies with large sample sizes are required to strengthen the evidence for an association.

Biography:

Sultan Al Dalbhi has completed his Clinical Fellowship in Nephrology and Clinical Research Associate degree from School of Medicine in McMaster University and University of Toronto. He is currently a Consultant Nephrologist at Prince Sultan Military Medical City, Riyadh, Saudi Arabia. He is very active as Clinical Researcher in diabetic nephropathy care and prevention.

Abstract:

Treatment with Renin Angiotensin Aldosterone System (RAAS) blockade including Angiotensin-Converting Enzyme inhibitors (ACEis) and Angiotensin II Receptor Blockers (ARBs) have been shown to improve clinical outcomes. However, recent contrasting evidence regarding the dual RAAS blockade has also been presented. Very few studies have investigated the eff ectiveness of this dual blockade among Diabetic Nephropathy (DN) patients in association with albuminuria or proteinuria that is why we did this review. A review of Randomized Controlled Trial (RCT) studies (n=45) reporting on the dose response analysis among DN patients using the RAAS blockade and other monotherapies over a 25-year period was performed. Overall, 45 studies of DN patients (n=18,628) with albuminuria or proteinuria were included. An association between dual RAAS blockade and DN was observed in which 18 of the 45 datasets revealed that combination therapies were eff ective among DN patients. Although there was a decline in albuminuria (mean diff erence: -19.93 mcg/L; 95% CI -50.32-10.47; I2=87.8%, p=0.000) and a slight decline in proteinuria (mean diff erence: -0.19 mg/mmol; 95% CI -2.32-2.70; I2=99.2%, p=0.000) with dual RAAS blockade combination therapy, these results demonstrated high heterogeneity among studies with non-signifi cant eff ects. Based on this study, it appears that dual RAAS blockade (or a combination of therapies) is a neutral treatment for patients with DN presenting with symptoms of albuminuria and/or proteinuria. Th erefore, other factors must be considered when recommending therapies for DN patients.

Biography:

Bart A Van Wagensveld has completed his MD in 1995 and PhD in 1998 from the University of Amsterdam, the Netherlands. He was a General Surgeon at the Academic Medical Center in Amsterdam, the Netherlands and specialized in Gastro-Intestinal and Laparoscopic surgery.

Abstract:

According to WHO, obesity is defi ned as an abnormal or excessive fat accumulation that presents a risk to health. It is measured based on the BMI (BMI (kg/m2) =Weight (kg) ÷ Height (m2)) Based on the BMI value people are classifi ed as underweight (<18.5), Normal (18.5-24.9), overweight (25-29.9), obesity (30-39.9) and morbid obesity (40+). Th e study shows that the main causes of obesity was peoples energy intake was high compared to expenditure which leads to increasing obesity levels. Worldwide obesity has more than tripled since 1975. In 2016, more than 1.9 billion (39%) adults (≥ 18 years) were overweight (39% of men and 40% of women). Of these over 650 million (13%) were obese (11% of men and 15% of women). Most of the world’s population lives in countries where overweight and obesity kills more people than underweight. 41 million children under the age of 5 were overweight or obese in 2016. In order to reduce the rate of morbid obesity, bariatric surgery is the only eff ective treatment with long-lasting results. Bariatric surgery leads to a reduction in mortality rates aft er 5Y, which translates to a decrease in the relative risk of death by 89%. It is also know that obesity is a major risk factor for developing T2DM, with 86% of T2DM patients being either overweight or obese in the UK from this study. Th us, signifi cantly higher diabetes remission rates were reported for gastric bypass (p<0.001) and biliopancreatic diversion (p<0.001) compared to medical therapy.

Biography:

Mohsina Hyder K is currently pursuing Doctoral degree at JSS College of Pharmacy, Ooty under JSS Academy of Higher Education and Research, Mysuru. Her project study is on prediabetes.

Abstract:

Prevalence of prediabetes has been increasing globally and it is estimated that 470 million people would have prediabetes by 2030. Progression to T2DM happens swift ly attributed to dietary patterns and sedentary lifestyle. T2DM carries high morbidity and has a huge health and fi nancial impact. Th e lack of knowledge among the prediabetics is the major factor contributing to failure in disease progression prevention. Recent studies highlight the importance of diabetes education programs. We aimed to organize Prediabetes Education Program (PEP) as 90% people with prediabetes are still unaware on it. Prediabetes Education Program is a cost eff ective strategy among health literacy for prevention and control of diabetes and its complications by preventing the prediabetes progression. Th is study involves construction and validation of KAP questionnaire for prediabetes. Th is is a self-administered 30 items questionnaire administered to prediabetes through medical screening camps conducted over selected districts of South India. Th e questionnaire development involved several steps like conceptualization, questionnaire design, literature review, experts review, pretest, pilot tests and also validation procedures like face validity, factor analysis and Cronbach’s alpha. Th e validated questionnaire was administered to 210 prediabetics including males and females under the age group of 25 to 55 years who participated in PEP at baseline and fi nal visit. Questionnaire showed satisfactory validity and reliability and fairly easy to read scores in readability tests. Outcomes were measured by comparing scores obtained before and aft er providing prediabetes education and counseling. Patient knowledge defi cits were identifi ed and proper counseling was provided. Signifi cant improvements were observed with the KAP domains of prediabetes towards disease management.

Biography:

Lailan Safi na Nasution is currently a Doctoral student in Biomedical Sciences, Faculty of Medicine, Universitas Indonesia. She is also working as a Lecturer in the Department of Nutrition Faculty of Medicine, Universitas Muhammadiyah Jakarta, Indonesia.

Abstract:

Studies reported autophagy gene expressions are increased in the visceral fat in obese persons, associated with obesityrelated cardio-metabolic risk. It wasn’t known whether this up-regulation diff ers in obese persons who were already fat from childhood compared to people who were under nourished at a young age. MAP1LC3B/LC3B (microtubule-associated protein 1 light chain 3β) is known as an autophagy-regulating gene. We used rats, a common test subject in obesity experimentation. We hypothesize that autophagy gene expression is higher in the visceral adipocytes of obese adult rats which were under nourished at childhood in comparison to obese adult rats which were already obese before-hand. Four-week-old male Sprague-Dawley rats, aft er acclimatization, were randomly assigned to three treatment groups given a low-caloric diet (n=5), a standard-caloric diet (n=5) and a high-fat diet (n=5) for 8 weeks. Aft erwards, all groups were fed a high-fat diet for 20 weeks. Th ere was a group fed with standard chow diet as control. Th e visceral adipose fat was then collected for PCR examination. Aft er the fi rst standard chow diet as control 8 weeks, the group was given a low-caloric diet which had a signifi cantly lower body weight than other groups. Aft er the following 20 weeks, this group experienced the highest change in body weight. Th e relative mRNA expression of the MAP1LC3B/LC3B of this group increased signifi cantly compared to control (p=0.047) and the high fat diet group (p- 0.037). In conclusion we found that obese adult rats that were under nourished at childhood have a higher relative autophagy gene expression compared to those who were previously normal or obese.

Biography:

James Joseph has completed his Masters in Engineering Business Management from University of Warwick, UK and has a Degree in Mechanical Engineering from the College of Engineering, Thiruvananthapuram.

Abstract:

For 60 years since its founding, Kerala took pride as the number one state in the country on life expectancy, receiving praise from world renowned global health expert, professor Hans Rosling. Prof Rosling puts Kerala ahead of Washington DC on Human Health Index at a fraction of per capita income. However, lifestyle diseases like diabetes is now in the order of an epidemic in the state reducing the life expectancy of our adult population above the age group of 30. For the fi rst time Kerala lost out its number one position on life expectancy to Jammu and Kashmir due to an alarming drop in life expectancy aft er the age of 30 compared to J&K as per 2010-14 census data. Root cause of our problem with diabetes and lifestyle diseases is the rapid increase of starch in our diet over the past 60 years through rice, wheat, and tubers like cassava. Th rough years of policy interventions we were able to make starch more aff ordable but the over correction is now hurting our health than helping it. In order for Kerala to get back and retain our number one position in life expectancy, we have to cut back our starch consumption from half a plate to a quarter and increase consumption of our grossly underutilized green jackfruits. Th is talk will scientifi cally explain why one of Kerala’s oldest traditions of eating green jackfruit as a meal is the perfect plate for diabetes and lifestyle diseases. Th e results from the fi rst glycemic research conducted on green jackfruit at Sydney University, fi rst randomized control trial on green jackfruit meal showing reduction in HbA1c are as follows. 1. Increased awareness from declaring Jackfruit as the Statefruit in March 2018 and the one meal campaign increased consumption of green jackfruit meal during the season, April to June, with prices sky rocketing to Rs 20 ($ 0.3) per Kg for a fruit which was mostly wasted. 2. From April 2018 the record showed a decline in Anti-diabetes medicine sales in Kerala government pharmacies reaching a 25% drop in May and June compared to March. 3. Aft er the Jackfruit season got over in July, sales started steadily increasing every month and by October it returned back to March 2018 level. 4. A review of three year sales record also showed month to month and year to year decline of medicine sales during the jackfruit season in 2018, while there was a month to month and year to year increase in sales aft er the season. Conclusions: Th e results clearly shows there is a defi nite relation between increased consumption of green jackfruit meal as an alternate to rice and reduced demand for diabetes medicine in Kerala during jackfruit season. And a rapid increase in Diabetes medicine sales when people switched back to rice aft er the season. Th is further shows the results already seen from the randomized control study on 36 patients can be reproduced on a larger population state wide. We now have a) internal product data to establish nutritional and glycemic advantage for green jackfruit, b) external interventional study on patients showing HbAa1c reduction with jackfruit meal and c) empirical evidence on reduction in demand for diabetes medication during jackfruit season. While Kerala is struggling to fi nd a solution to contain its rapidly increasing health care costs and early deaths from life style diseases like type 2 diabetes, this study shows there is a signifi cant opportunity to conduct a multi-center clinical trial on green jackfruit meal as an alternate to rice and formulate policies to use its mostly wasted natural resource, green jackfruit as a medical nutrition therapy like the Mediterranean diet recommended by ADA.

Biography:

Ajmila Islam is currently working as an Assistant Professor of Natural Sciences at the American University in Dubai. She has also worked in the area of Microbiology and Molecular Biology. She has published research works in colorectal cancer and obesity.

Abstract:

Whole grains, which are less-processed forms such as whole wheat, brown rice and oats digested more slowly than refi ned grains. It is speculated that they have a greater eff ect on maintaining proper balance in blood sugar and insulin levels, which may help keep hunger level low and creates satiety. Th is is also true for most vegetables and fruits, which contain high fi ber. Th ese low glycemic index foods have tremendous benefi ts for disease prevention, as well as there is also evidence that they can help prevent weight gain. Th e evidence for weight control is much stronger for whole grains than it is for fruits and vegetables. Th e most recent Harvard School of Public Health diet and lifestyle change study supports that people who increased their intake of whole grains, whole fruits (not fruit juice) and vegetables over the period of 20 years gained less weight. Th is study supports the fact that when people increase their intake of these foods, they cut back on calories from other foods. Fiber is one of the components that may be responsible for off ering weight control benefi ts of these foods, since fi ber slows digestion and helps in controlling hunger. On the other hand, fruits and vegetables are high in water, which may help people feel fuller on fewer calories.

Biography:

Tigist W. Leulseged is a medical doctor and public health specialist currently working as a lecture at Endocrinology unit under Department of Internal Medicine, St. Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia. Her research interests are chronic illnesses particularly diabetes epidemiology including gestational diabetes, treatment, patient involvement in effective management and quality of services provided. She has experience in related research areas in both hospitals and teaching institutions.

Abstract:

Background: Diabetes is a chronic, progressive disease characterized by elevated levels of blood glucose. Poorly managed diabetes leads to serious complications and early death. Th e prevalence of diabetes has been increasing over the past few decades. Ethiopia is one of African countries with the highest number of people living with diabetes. Studies conducted in Ethiopia and other countries mainly focused on level of glycemic control at one point in time. Studies targeting the time that a patient stayed in a poor glycemic level are lacking. Objective: To estimate time to fi rst optimal glycemic control and to identify prognostic factors among Type-2 Diabetes Mellitus (T2DM) patients in public teaching hospitals in Addis Ababa, Ethiopia. Methods: A hospital based retrospective chart review study was conducted from April to July 2018 at diabetes clinic of Addis Ababa’s public teaching hospitals among randomly selected sample of 685 charts of T2DM patients who were on follow up from January 1, 2013 to June 30, 2017. Data was collected using pretested data abstraction tool. Data was checked, coded and entered to Epi-Info V.7.2.1.0 and exported to SPSS V.23.0 and STATA V.14.1 for analysis. Descriptive statistics is presented with frequency tables, Kaplan- Meier plots and median survival times. Association was done using Log-rank test and Cox proportional hazard survival model, where hazard ratio, P-value and 95% CI for hazard ratio were used for testing signifi cance and interpretation of results. Results: Median time to fi rst optimal glycemic control among the study population was 9.5 months. Th e major factors that aff ect it are age group (HR=0.635, 95% CI: 0.486-0.831 for 50-59 years, HR=0.558, 95% CI: 0.403-0.771 for 60-69 years and HR=0.495, 95% CI: 0.310-0.790 for ≥70 years), diabetes neuropathy (HR=0.502, 95% CI: 0.375-0.672), more than one complication (HR=0.381, 95% CI: 0.177-0.816), hypertension (HR=0.611, 95% CI: 0.486-0.769), dyslipidemia (HR=0.609, 95% CI: 0.450-0.824), cardiovascular disease (HR=0.670, 95% CI: 0.458-0.979) and hospital patient treated at (HR=1.273, 95% CI: 1.052-1.541). Conclusion: Median time to fi rst optimal glycemic control among T2DM patients is longer than expected which might imply that patients are being exposed to more risk of complication and death.

Biography:

Vani Pulijala is the Founder of Astra Healthcare Private Limited. She has 15 years of experience in the healthcare industry. She has completed her MBBS from Kakatiya Medical College Warangal and her Post-graduation MD in Biochemistry from Gandhi Medical College, Hyderabad. She has completed Fellowship in Applied Nutrition and also a Certifi cate degree in Human Applied Nutrition from Cambridge, UK and is practicing as a Clinical Nutritionist. Her research interest studies is on the Indian spices on prevention and treatment of metabolic diseases, teach the rural India about the importance of perfect and balanced nutrition to prevent malnutrition in rural and tribal areas of India.

Abstract:

Chronic diseases are a major burden, creating a global warning in today’s world. Our aim was to study the role and eff ectiveness of tea (Camellia sinensis) in preventing the burden of chronic diseases, like diabetes, hypertension, thyroid, cancer, PCOS, osteoarthritis, etc. Th ere are a many studies and publications, supporting the statement that tea has a potential eff ect in reducing the burden of chronic diseases. Only confusion that is bothering the public all around the world, is actually regarding the exact amount of intake of tea and the variants of tea which should be taken on a daily basis to attain all the hidden healthy benefi ts of the second most commonly consumed drink in the world, which is tea. Th is presentation was taken up to reveal the clear picture of such queries. Th ere was a positive correlation between the regular intake of minimum 4 cups of tea daily and reduction in the incidence of chronic diseases. Black tea, green tea, white tea, oolong tea are few of the variants of tea which has tremendous benefi ts in regulating the metabolism of our body, thus preventing the metabolic disease burden all around the world.