Scientific Program

Day 1

KEYNOTE SPEAKERS
  • A unified pathophysiologic construct of diabetes and its complications, including malignancies, in the context of the beta-cell–Classification of Diabetes

    Perelman School of Medicine
    USA
    Biography

    Dr. Schwartz received his MD from the University of Chicago, completed his residency at the University of Pennsylvania and an Endocrine Fellowship at the University of Chicago.

    Abstract

    We have previously presented a proposal for a new, beta-cell centric classification of diabetes based on a consilience of genetic, metabolic, and clinical research that have accrued since the current classification was instituted. It recognizes that the beta-cell is the core defect in all patients with diabetes. Differences in the genetics, insulin resistance, environment and inflammation/immune characteristics of the damage to the beta-cell in each individual will determine the phenotypic presentation of hyperglycemia and allow for a patient-centric, precision-medicine therapeutic approach, part of which we labeled ‘the Egregious Eleven’. We now recognize the same pathophysiologic mechanisms that account for damage to the beta-cells govern the susceptibility of the cells involved in the complications of diabetes to damage by the now well-defined abnormal metabolic environment that typifies beta-cell dysfunction. This abnormal metabolic environment is typified by oxidative stress which alters metabolic pathways a la Brownlee’s Hypothesis model, alterations in gene expression, epigenetics, and inflammation. This unified pathophysiologic construct of diabetes and its complications, including malignancies, in the context of the B-cell–Classification of Diabetes allows us to understand the varied risk of developing complications of diabetes with similar levels of glycemic control, how non-glycemic effects of some medications for diabetes result in marked complication risk modification and the value treating co-morbidities of diabetes in effecting complication risk. Principles we outlined in using ‘the Egregious Eleven’ model- use agents that preserve beta-cell function, treat with least number of agents that treat most number of mechanisms of hyperglycemia- can be extended to use those agents, in combination, that also engender weight loss, and decrease CV outcomes. This approach allows for a more accurate assessment and treatment of each patient’s disease and effecting true precision medicine. We also believe that the same pathophysiologic mechanisms that account for damage to the beta-cells and govern the susceptibility of the cells involved in the complications of diabetes are likely to explain the association of cancer and cognitive deficiencies to diabetes and obesity, explaining why a diabetic medication may affect cancer risk and therapy.

  • The business of medicine: The top 10 regulatory risks faced by endocrinologists and their practices

    Abstract

    The business practices of Endocrinologists are under the regulatory microscope. Medicare, Medicaid and private payors are actively conducting audits of endocrinology claims for reimbursement. In this session, we will discuss a number of existing risk areas and what Endocrinologists and their practices should expect in 2019.Specific Objectives include: 1. Participants will learn about the current Federal and State enforcement efforts and initiatives to identify and prosecute health care fraud. 2. Participants will learn about the efforts of “Special Investigations Units” working for private payors to identify improperly paid claims and refer instances of fraud to the government for possible prosecution. 3. Participants will learn about a number of the common medical necessity, documentation, coding and billing errors identified when auditing medical records and claims documentation. 4. Participants will learn how to reduce their level of regulatory risk and liability.

Diabetes Metabolism and Obesity diseases | cardiovascular diseases | Diabetes Pathophysiology | Diabetes Complications | Diabetic Nutrition | Diabetes Science and Technology | Diabetes: Research | Alternative medicine for Diabetes
Chair
  • Allied Academies Diabetes Conference 2018 Chair Speaker JMA Hannan photo
    JMA Hannan
    Independent University, Bangladesh (IUB)
    Bangladesh
Speaker
  • Potential benefits of Chia seeds in prevention of cardiovascular diseases
    Speaker
    Beatrice Nyanchama Kiage Mokua
    Jomokenyatta University of Agriculture and Technology, Kenya
    Kenya
    Biography

    Beatrice Nyanchama Kiage Mokua has completed her PhD at the age of 37 years from Christian Albrechts University (CAU), Kiel, Germany. She is a lecturer at Jomokenyatta University of Agriculture and Technology at the department of food science and technology. She has papers in reputed journals.

    Abstract

    Potential benefits of Chia seeds in prevention of cardiovascular diseases

  • Entrenched obesity deterrents demand radical measures
    Speaker
    James L DeBoy
    Lincoln University
    USA
    Biography

    James L. DeBoy, PhD Department of Health Sciences Lincoln University of PA

    Abstract

    Despite multiple, well-intentioned individual-based strategies to reverse America’s obesity epidemic for the past 30 years, obesity rates continue to climb: almost 40 percent of adults were obese in 2016 with another 27 percent classified as pre-diabetic (CDC, 2018). Missing from this battle of the bulge is a population-based approach that would model the one deployed during the anti-smoking campaign of the 1980s and beyond. Societal/legislative actions, while perceived by many as draconian and “un-American”, must be implemented if we are ruly serious about addressing this national health crisis. A 15 PowerPoint slide presentation will identify obesity prevention deterrents, limitations of individual-based approaches, the nutritional shift in today’s food supply, and suggested societal, legislative interventions as well as the rationale that accompanies them.

  • Motivational self monitoring and digital healthcare technology
    Speaker
    James Minor
    Clement J Zablocki Veterans Affairs Medical Center
    USA
    Abstract

    Diabetes and consequent complications are creating a global epidemic costing billions of dollars in healthcare expenses. Our biofeedback concept can improve patient healthcare and avoid such complications. This talk introduces simple diagnostic images of the daily impact of diabetes on blood sugar that will encourage and motivate patients toward more effective self monitoring and improved blood glucose control. Recent publications reported these patterns hidden within the multiday profiles of blood glucose fluctuations. The studies support clinical benefits such as an accurate 24-hour advanced alert for incident extreme glycemia, such as hypoglycemia. The patterns measure healthcare effectiveness and indicate actions necessary to control expected glycemic conditions. This talk reports the benefit of these diagnostic images in a clinical case spanning multiple months.

  • Impact of providing working lunch on health: A case study in stich right limited firm at Tongi in Dhaka
    Speaker
    Rafia Rahman
    University of Dhaka
    Bangladesh
    Biography

    Rafia works with national and international NGOs for around nine years then an academician. Her wishes to increase, ensure health care services by registered trained provider in the countries, with this view this frame work was make. Being a physician, academician and a researches, she fell this model will work for all developing countries.

    Abstract

    Impact of providing working lunch on health: A case study in stich right limited firm at Tongi in Dhaka

Day 2

KEYNOTE SPEAKERS
  • Spirulina platensis stimulates glucose-stimulated insulin secretion in perfused rat pancreas and BRIN-BD11 cells through the cAMP-dependent PKA pathway

    Independent University, Bangladesh (IUB)
    Bangladesh
    Abstract

    The antihyprglycemic effects of Spirulina platensis has previously been reported in rats and humans. In this study the effects of S. platensis were evaluated on insulin secretion together with exploration of its mechanism underlying insulin action in isolated perfused rat pancreas and BRIN-BD11 cells. The ethanolic extract was successively partitioned using hexane, chloroform, ethylacetate and 1-butanol. Butanol part was dissolved in Krebs-Ringer bicarbonate (KRB) buffer solution (pH adjusted to 7.4), continuously bubbled with O2 and perfused, via a cannula into the aorta, to the celiac and mesenteric arteries of pancreas, isolated by surgery under pentobarbital anesthesia. Insulin in the effluent (collected from a cannula in the portal vein at 1 min interval) was measured by an ELISA technique with a rat insulin assay kit. Insulin secretory activity was also observed using rat clonal ?-cells (BRIN-BD11 cells). For the studies on the mechanism underlying the insulin secretory activity, 16.8 mM glucose, 30 mM KCl, 50 µM verapamil, 300 µM diazoxide and 10 mM theophylline were used.

Diabetes Science and Technology | Diabetes: Research | Diabetic Nutrition | Obesity and diet | Maternal Obesity | Weight Management | Diabetes Pathophysiology | Diabetes Complications
Chair
Speaker
  • Type 2 Diabetic Nepalese Immigrant’s Knowledge of Diabetes Self-Management in England
    Speaker
    Ramji Tiwari
    University of Southampton
    United Kingdom
    Biography

    Ramji Tiwari PhD Student ( Diabetes Selfmanagement) Building 45 Centre for Innovation and Leadership in Health Sciences High Field campus University of Southampton University Road, Southampton

    Abstract

    The study has examined the effect of age, diabetes related perceived and actual knowledge on body mass index (BMI) amongst type 2 diabetic Nepalese immigrants of Rushmoor in Hampshire County, England. A cross-sectional questionnaire survey was carried out among type 2 diabetic patients from 30 September to 7 November 2017. A total of 43 (male 29, female 14) individuals with diabetes were recruited through purposive convenient sampling. They were consented, completed a questionnaire and self-reported HbA1c and cholesterol. Blood pressure, height, and weight were measured. Data were collected at local community centres using the translated version of study materials including the questionnaire.

  • Anti-hyperglycemic action of Gynura procumbens is partly mediated by inhibition of carbohydrate digestion and absorption in the gut
    Speaker
    Kazi Ishtiaq Ahmad
    Independent University, Bangladesh (IUB)
    Bangladesh
    Biography

    Independent University

    Abstract

    Gynura procumbens leaf has been widely used as a traditional therapy for diabetes all over the world. Present study aims to investigate effects of G. procumbens in sucrose digestion and absorption in the gut to explore the anti-hyperglycemic activity of this plant. The dried-powder-leaves of G. procumbens were extracted with methanol. Sucrose malabsorption in GI Tract was evaluated in 20-hrs-fasted Long Evan rats by determining the amount of sucrose remaining in six different parts of gastrointestinal tract after sucrose load (2.5 g/kg b.wt), with or without 500 mg/kg dose of G procumbens extract. For evaluation of disaccharides activity, the extract was fed to 20-h-fasted rats. After 60 min, the rats were sacrificed, and the small intestines were isolated and homogenized. The homogenate (20 ?l) was incubated for 60 min at 37 °C with 40 mmol sucrose. Disaccharides activity was calculated by glucose converted from sucrose as ?mol-mg glucose/protein/h. When the extract of G procumbens was administered simultaneously with the sucrose load, the residual sucrose content in the gastrointestinal tract was increased significantly (p<0.01), especially in the upper intestine at 30 min, in the whole intestine as well as cecum at 1 and 2 h. At 4 h, sucrose was not detected in the gut in both groups. When extract was supplemented with the glucose solution, the percentage absorption of glucose was decreased by 13 - 19% during whole perfusion period (p<0.05). It inhibited disaccharides (sucrose) activity significantly (p<0.05) in rats. The anti-hyperglycemic activities of G procumbens in rats are partly mediated via delaying intestinal carbohydrate digestion and absorption

  • Special Session
    Functional potential of a sub-GWAS noncoding variant in modulating the trait phenotype
    Speaker
    Khushdeep Bandesh
    National Institute of Diabetes and Digestive and Kidney Diseases, USA
    USA
    Abstract

    Decades of rigorous genetic efforts have established Type 2 Diabetes (T2D) as apparently an outcome of altered metabolic traits. In this regard, C-peptide, a byproduct of insulin synthesis has been largely neglected. Owing to a higher plasma half-life (~30mins) than insulin (~4 mins), C-peptide is a precise measure for insulin secretion and presents independent functional activity. We performed a two-staged Genome Wide Association Study (GWAS) for plasma C-peptide in Indians (N = 2,706) and identified a novel variant rs4454083 at sub-GWAS significance residing in intron of a GABA receptor-subunit gene - GABRA6 and simultaneously, in exon of a novel antisense lncRNA, which we named ARBAG. Expression of GABRA6 triggers fast inhibitory neurotransmission in human cerebellum and its recruitment to postsynaptic sites is administered by C-peptide. Imputation and targeted sequencing of associated region ensured that rs4454083 is a ‘stand-alone’ SNP. The variant allele (G) which is a minor allele across all world populations, was seen to be associated with remarkably higher ARBAG expression in cerebellum. A strong correlation was detected in expression of GABRA6 and ARBAG in human cerebellar cell-line. Presence of G allele was observed to stabilize lncRNA transcripts therefore leading to cellular abundance of ARBAG. Overexpression of ARBAG led to cleavage of full-length GABRA6 mRNA at/ around the site of complementarity between both RNAs and ended up in a dissociated GABRA6 protein which is rendered non-functional owing to separation of its ligand binding domain from trans-membrane domain. The findings demonstrate role of a sub-GWAS intronic variant in regulating functional mRNA isoforms of associated protein gene.

  • Video Presentation
    From energy and food nutrition via metabolism to diabetes control and risk reduction of complications
    Speaker
    Gerald C. Hsu
    EclaireMD Foundation
    USA
    Biography

    Gerald C. Hsu received an honorable PhD in mathematics and majored in engineering at MIT. He attended different universities over 17 years and studied 7 academic disciplines. He has spent 20,000 hours in T2D research. First, he studied 6 metabolic diseases and food nutrition during 2010-2013, then conducted his own diabetes research during 2014-2018. His approach is a “quantitative medicine” based on mathematics, physics, optical and electronics physics, engineering modeling, signal processing, computer science, big data analytics, statistics, machine learning, and AI also known as “math-physical medicine”. His main focus is on preventive medicine using prediction tools. He believes that the better the prediction, the more control you have.

    Abstract

    The author uses “math-physics medicine” instead of the traditional biochemical medicine to study the situation of energy imbalance transmitting into metabolic disorders, resulting in chronic diseases and their complications. He applied energy theory to study the disequilibrium between energy infusion, as in food nutrition intake, and energy consumption, such as exercise, work, and activities. These energy imbalances are caused by poor lifestyle management and shown as metabolic disorders, involving weight, glucose, blood pressure, and lipids. In 2014, he developed a metabolism equation using structural engineering modeling and various mathematics techniques. During 2015 to 2017, he developed a postprandial glucose (PPG) prediction model by applying optical physics and signal processing techniques. During 2015 to 2016, he developed a fasting plasma glucose (FPG) prediction model by applying energy theory and spatial analysis techniques. Finally, he used big data analytics, machine learning, and artificial intelligence to process and analyze ~1.5 million data associated with four chronic diseases, especially type 2 diabetes and its complications.

  • video presentation
    From weight management via diabetes control to cardiovascular risk reduction
    Speaker
    Gerald C. Hsu
    EclaireMD Foundation
    USA
    Biography

    Gerald C. Hsu received an honorable PhD in mathematics and majored in engineering at MIT. He attended different universities over 17 years and studied 7 academic disciplines. He has spent 20,000 hours in T2D research. First, he studied 6 metabolic diseases and food nutrition during 2010-2013, then conducted his own diabetes research during 2014-2018. His approach is a “quantitative medicine” based on mathematics, physics, optical and electronics physics, engineering modeling, signal processing, computer science, big data analytics, statistics, machine learning, and AI also known as “math-physical medicine”. His main focus is on preventive medicine using prediction tools. He believes that the better the prediction, the more control you have.

    Abstract

    From weight management via diabetes control to cardiovascular risk reduction

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