Day 1 :
Keynote Forum
Geetendra Singh Dhanawat
Aditya Bharti Centre for Diabetes & Family Medicine, India
Keynote: Relevance of HOMA-IR2 in clinical practice: Should be use it as routine diagnostic tool?
Biography:
Geetendra Singh Dhanawat is an eminent diabetologist (Mumbai, India), completed his PG from CMC Vellore in Family medicine & MPH from Global University. He is fellow of Royal society of Public health & Completed his Fellowship in intensive care medicine from Apollo Hospital. He has special interest in diabetes and disease prevention. He completed PG Diabetology from John Hopkins University school of Medicine & Dip. Diabetes from Stonebridge University, UK. He is a Consultant Diabetologist. He has published several papers in reputed journals including Journal of WAO (World Allergy Organization). Member of Research society for study of Diabetes in India RSSDI.
Abstract:
Homeostatic model assessment (HOMA) is a method for assessing β-cell function and insulin resistance (IR) from basal (fasting) glucose and insulin or C-peptide concentrations. The HOMA model is used to yield an estimate of insulin sensitivity and β-cell function from fasting plasma insulin and glucose concentrations. The relationship between glucose and insulin in the basal state reflects the balance between hepatic glucose output and insulin secretion, which is maintained by a feedback loop between the liver and β-cells. Decreases in β-cell function were modeled by changing the β-cell response to plasma glucose concentrations. Insulin sensitivity was modeled by proportionately decreasing the effect of plasma insulin concentrations at both the liver and the periphery. Although it has been argued that HOMA is no better than fasting insulin concentrations but, there are several reasons why the use of HOMA in normal subjects is worthwhile. The use of HOMA to quantify insulin sensitivity and β-cell function can be helpful in normal populations as it allows 1) comparisons of β-cell function and insulin sensitivity to be made with subjects with abnormal glucose tolerance and 2) the collection of longitudinal data in subjects who go on to develop abnormal glucose tolerance. However, if the β-cell data are reported in isolation, one might conclude erroneously that the subject had failing β-cells, as opposed to appropriately low secretion, because the sensitivity of the body was high. In conclusion, the HOMA model has proved be a robust clinical and epidemiological tool in descriptions of the pathophysiology of diabetes. Already become one of the standard tools in the armamentarium of the clinical physiologist.
Keynote Forum
Jan Leendert Pouwel Brouwer
PRA Health Sciences, Netherlands
Keynote: QTc evaluation in drug development: QTc prolongation and concern for Torsades des pointes risk in modern drug development
Biography:
Jan Leendert Pouwel Brouwer completed his MD training and internships at the University of Groningen, Netherlands. There he also worked at the department of hematology as a coagulation specialist. He obtained his PhD thesis at the same University. Dr Brouwer is a board certified cardiologist and was trained at the Radboud University in Nijmegen, Netherlands. He has published more than 25 papers in international peer reviewed journals. Currently he is working as a cardiologist and medical director at a CRO and a thrombosis service center.
Abstract:
Assessing the cardiovascular safety of novel compounds is an important clinical drug development objective for drugs with preclinical cardiovascular safety signals and agents for which a cardiovascular class effect is suspected. Consequently for most compounds, regulatory authorities still expect to see a Thorough QT (TQT) study according to FDA guideline ICH-E14. Evaluation of ECG’s during these early clinical studies typically involves the assessment of clinically significant, abnormal ECG’s only. If statistical analysis is performed, traditionally it has been limited to descriptive statistics of ECG parameters. Combined with Concentration Effect Modelling (CEM), precise estimates of QTc effect may substantially improve the ability to detect QTc prolongation early in the development process. For both small and large molecules, a rigorous assessment of the ECG during early clinical studies can turn out to be an excellent long-term investment. Assessing effects of your drug on ECG parameters requires experience and the right study design, study assessments and data analysis methods. For any TQT study or an early clinical study, the right experience and expertise in study design and execution is needed. Procedures and methods to deliver will be discussed.
- Insulin and Beta Cell Targeting | Balanced Diet and Chronic Diseases | Pharmaceutical Diabetes Treatments and Diagnosis | Current Research in Cardiology | Lipid Metabolism and Diabetes | Type 2 Diabetes and Its Treatments
Session Introduction
Emran Dawoud
The Wellness Center, Kuwait
Title: Integrative nutrition and chronic diseases
Time :
Biography:
Emran Dawoud completed his Ph.D. in Health Physics which is part of the Nuclear Engineering Department from the University of Tennessee, Knoxville. Started his career at Oak Ridge National Laboraory, Oak Ridge, TN and Kuwait Institute for Scientific Research. Also filled several faculty positions at different schools in the US, Kuwait and Jordan. Five years ago, his wife was diagnosed with triple negative Invasive Ductal Carcinoma. In his journey looking for answers to the root causes of cancer, earned an Integrative Nutrition diploma from the Institute for Integrative Nutrition, New York and became an activist promoting life style changes to overcome common chronic diseases like obesity, diabetes, hypertension, cardiovascular diseases, cognitive diseases and autoimmune diseases.
Abstract:
Wellness is a health program based on integrative nutrition, which is a comprehensive nutrition program that integrates dietary needs with lifestyle variables including physical activity, relationships, spiritual practices, and career. It promotes the idea of connecting the health of the body, mind and soul. In the past decade there has been a growing epidemic of obesity and diabetes worldwide and this has been attributed to several factors, such as poor dietary habits and sedentary lifestyles. The aim of our program is to tackle this epidemic. Dietary changes are the first line of treatment for type 2 diabetes. These changes usually revolve around reducing sugar intake; however studies have shown that a more detailed dietary plan is required to enhance the sensitivity to insulin. Varying degrees of carbohydrate intake affect the metabolic process. For example, a low-carb diet requires the release of insulin to metabolize glucose through the mTOR signalling pathway, while in a ketogenic diet, the depletion of glycogen stores results in the release of insulin through the AMPK pathway. Dietary plans are based on caloric intake and/or the constituent macronutrients; those two factors affect the metabolic activity of an individual, but are not the sole contributors. The concept of integrative nutrition assesses the impact of other factors on the metabolic process. Metabolism occurs through a chain of chemical reactions during which different enzymes and hormones are released. This process is affected by the previously mentioned life style variables. A recent study showed that chronic stress causes massive release of glutamate which acts on certain neuro-receptors, resulting in the activation of a specific enzyme that prevents cell adhesion causing cognitive impairment. An integrative approach to dietary plans and lifestyle changes offers patients a practical tool to gain control over their obesity and diabetes. Our main goal with Wellness is to combat this epidemic and guide clients on their journey to a healthier life. In my integrative nutrition practice as a counsellor, several diabetic clients managed to control their sugar and reduce it to acceptable limits within the six months duration of the program. They also managed to control their hypertension and consequently reduce their weight, thereby improving their overall health.
Biography:
Abubakar Hilal has a special interest in Interventional cardiology which is one of the main clinical specialty and pillar of cardiology. He believes in building strong team environment and fostering open communications. He wishes to follow a career in teaching & research in cardiology and work in an Institute to help in developing essential clinical skills required for future under graduate & post graduate cardiology students. He is capable in his critical appraisal skills when evaluating information in the cardiology literature.
Abstract:
Pacemaker lead displacement or dislodgement is one of uncommon cause of pacemaker malfunction. It occurs due to unintentional or deliberate manipulation of the pacemaker pulse generator in the skin pocket by the patient. This leads to lead coiling, dislodgement and pacemaker failure. Elderly people mostly female, psychiatric patients and large pocket size mostly present with this problem. Mostly occurs in first year of pacemaker implantation. CXR is the diagnostic modality. Pacemaker lead repositioning is the treatment along with proper suture fixation of the lead and pulse generator within its pocket.
Geetendra Singh Dhanawat
Aditya Bharti Centre for Diabetes & Family Medicine, India
Title: Incorrect informations affecting the outcome of treatment – A survey conducted among Indian people regarding diabetes knowledge
Biography:
Geetendra Singh Dhanawat is an eminent diabetologist (Mumbai, India), completed his PG from CMC Vellore in Family medicine & MPH from Global University. He is fellow of Royal society of Public health & Completed his Fellowship in intensive care medicine from Apollo Hospital. He has special interest in diabetes and disease prevention. He completed PG Diabetology from John Hopkins University school of Medicine & Dip. Diabetes from Stonebridge University, UK. He is a Consultant Diabetologist. He has published several papers in reputed journals including Journal of WAO (World Allergy Organization). Member of Research society for study of Diabetes in India RSSDI.
Abstract:
India is home to over 60 million adults with diabetes (7.8% of the population), of which more than 30 million are undiagnosed or untreated, thus increasing the risk of developing complications and premature mortality. Given the challenges in early detection and management of diabetes, it is imperative to seek innovative ways that help to expand the reach of health literacy and services among the general population and high risk groups, while also improving management and quality of life in confirmed diabetics. In September 2019, we planned & conducted a survey at pan India level through various medical colleges OPD. This survey is conducted in 63 medical colleges with the help of first year & second year MBBS students. We planned a short survey and responses taken into Google survey sheet. Total 4725 candidates participated in survey & the selection of these candidates was random. The survey outcome is - Some very popular diabetes related myth taken into consideration:
• People with diabetes cannot lead a normal life – Yes (79%); No (18%) No idea (3%)
• Diabetes is more common in Men – Yes (56%); No (31%) No idea (13%)
• Testing urine sugar alone is sufficient for diagnosing diabetes – Yes (9%); No (61%) No idea (30%)
• People with diabetes should not donate blood – Yes (88%); No (4%) No idea (8%)
• Diabetes can be cured – Yes (59%); No (28%) No idea (13%)
• All types of diabetes are same – Yes (39%); No (28%) No idea (33%)
• Diabetes does not develop after 60 years – Yes (27%); No (21%) No idea (52%)
• People with Type 1 diabetes have short span of life – Yes (89%); No (8%) No idea (3%)
• People with diabetes should not travel – Yes (45%); No (51%) No idea (4%) • Drugs for diabetes should never be withdrawn – Yes (66%); No (13%) No idea (21%)
• We can relax the diet regimen when diabetes is under good control – Yes (59%); No (31%) No idea (10%)
• Fruits are to be avoided – Yes (89%); No (4%) No idea (7%)
• Consumption of sugar may cause diabetes: Yes (81%); No (9%) No idea (10%)
• Bitter fruits & Herbs can cure diabetes completely: Yes (72%); No (8%) No idea (20%)
• Some forms of yoga can cure diabetes: Yes (61%); No (19%) No idea (20%) • Insulin treatment is last resort in diabetes treatment: Yes (99%); No (1%) No idea (0%)
The survey reveals very interesting data & shows us the impact of awareness on treatment outcome. These are various misconceptions regarding diabetes in the common population. In conclusion, proper diabetes management should include a better counseling to patients and relatives & some printed form of information should also be given to the patient to circulate in his or her near vicinity to educate others. Empower the patient with right knowledge for better treatment outcome. Keep the patient in touch & ask about treatment compliance.
Shumoos H Alwaid
Islamic University College, Iraq
Title: Study the interrelation between Oxidized Low-Density Lipoprotein (Ox-LDL) with diagnostic criteria of metabolic syndrome patients
Biography:
Shumoos H Alwaid has completed her Bachelor of degree in Biology from College of Sciences and MSc and PhD from Kufa University, College of Sciences. She is currently working in teaching field at The Islamic University, College of Medical Techniques.
Abstract:
Metabolic Syndrome (MetS) is a worldwide distributed public health problem and its incident in increase. MetS is characterized by clustering of several metabolic abnormalities including central (intraabdominal) obesity, dyslipidemia, hyperglycemia and hypertension. The ultimate importance of this cluster is to identify individuals at high risk of both type-2 diabetes and Cardiovascular Disease (CVD). Oxidized Low- Density Lipoprotein (Ox-LDL) which result from oxidation of LDL cholesterol is an aspect of oxidative stress. The concentration of circulating Ox-LDL has shown relationships with atherosclerotic disease, cardiovascular diseases and some studies indicate OxL-DL concentrations to be increased in the metabolic syndrome. The aim of the study is to evaluate the serum level of Ox-LDL in MetS patients regarding to metabolic syndrome risk factors, age, gender, body mass index and waist circumference. A total of the (130) participant involved in this study, blood samples had been collected from the (90) MetS patients (50 female and 40 male) and from (40) individuals who were obviously healthy as a control group. The result of the study showed a significant increase in concentration of serum Ox-LDL in MetS patients when compared with healthy group and significant differences of Ox-LDL concentration in serum among different ages groups of Mets female and males population. In regarding to BMI, the result showing significant increase Ox-LDL concentration in morbid and obese weight when compare with over weight in male MetS population. This study also indicated, there is a significant positive correlation among Ox-LDL with T. cholesterol, TG-C, LDL-C and blood sugar while negative correlation with HDL-C in all patients groups.
Shehzano Fakir Muhammad Kasim
Ziauddin University, Pakistan
Title: Parental history of type-2 diabetes is a threat to gene
Biography:
Shehzano Fakir Muhammad Kasim has completed his BDS from Jinnah Medical and Dental College, Karachi, Pakistan and MPhil from Ziauddin University, Pakistan.
Abstract:
Diabetes is a metabolic disease categorized by increase blood sugar level resulting from defects in insulin excretion, insulin function or both. The prolonged diabetes is associated with damage, dysfunction and failure of different organs especially the eyes, kidneys, nerves, heart and blood vessels. Initially diabetes was considered as a disease of western countries but its existence is virtually seen in every nation-state of world. The present prevalence in Pakistan of type-2 diabetes mellitus is 26.3%. Out of them 19.2% are known with the disease while 7.1% were newly diagnosed people. Diabetes is presently the fastest emergent epidemic disease and has been recognized to a collision between genes and the environment. Worldwide burden of disease was 382 million people in 2013 and this number will increase to 592 million by 2035. Parental history of diabetes is a chief factor for development of type-2 diabetes mellitus, but whether this association derives from shared genetic or environmental factors is unclear. Persistently high blood sugar levels can result in drastic outcomes like diabetic ketoacidosis and Hyperosmolar nonketotic syndrome. Association of gene variants and family history will help in identification of disease. Previous studies show that type-2 diabetes mellitus is associated with following genes: PPARG, TCF7L2, FTO, CDKN2A/2B, HHEX/IDE, SLC30A8, KCNQ1, JAZFI, IRSI, KLF14, CHCHD9 and DUSP9. This review highlights the role of different genes in the development of type-2 diabetes mellitus and parental history which causes the disease is a big threat to all genes that cause the disease.
Samra Abouchacra
Al Ain Hospital, UAE
Title: Why diets fail? A role for “Eat-ology†as a disruptive weight loss methodology
Biography:
Samra Abouchacra has had extensive clinical and academic experience in Canada and UAE. She has Canadian & American Board certification in Internal Medicine & Nephrology and Masters in Science from the Toronto Institute of Medical Sciences. She is the founder and previous chairperson for Academic Affairs department and previous chairperson of Nephrology department at Tawam Hospital. She also served as medical director of Urology Kidney Disease Service Line Council for the Emirate of Abu Dhabi and has recently held the post of Director of Outpatient Services at Tawam and now Al Ain Hospital in preparation for commissioning of the new facility. She has been actively participating in teaching and research activities with numerous publications in peer review journals and among country investigators for the International Dialysis Outcomes and Practice Patterns Study (DOPPS). She has membership in national & international medical societies and is a fellow of American Society of Nephrology.
Abstract:
Obesity has become a global epidemic, which is rapidly spreading at phenomenal rates. The gravity of this “Globesity” epidemic goes beyond sheer numbers, as it is directly linked to numerous diseases that pose serious health risks and are responsible for escalating health care expenditures. Obesity is the single most important contributor to development of type 2 diabetes along with other metabolic disorders, all of which individually increase cardiovascular morbidity and mortality. Though the solution seems straightforward with weight reduction being the best cure, however, achieving and maintaining weight loss is extremely challenging. Diets have disappointingly had limited short term benefits with lack of sustainability and even rebound weight gain. In addition to their restrictive nature, there are even more complex personal behaviour and social factors affecting food ingestion that current day “diets” do not address. This lecture will highlight these shortcomings and explore dietary behaviour patterns promoting weight gain that may be critical in sabotaging weight loss efforts. Our GERG research group has undertaken a number of research initiatives including a multicentre survey aimed at understanding eating habits in overweight and obese individuals in our region. The published data will be shared for interactive discussion. Furthermore, a recently published novel eating behaviour modification concept called “Eat-ology” will be introduced. This intervention empowers individuals to identify their own specific “Eating Errors” and imparts techniques to convert them into “Eating Essentials.” In this way, Eat-ology not only circumvents many of the shortfalls of today’s “diets,” but through non-restrictive, simple and practical principles it may enable the transformation of one’s “way of eating” to support weight loss and its long term maintenance.
Samra Abouchacra
Al Ain Hospital, UAE
Title: Why diets fail? A role for “Eat-ology†as a disruptive weight loss methodology
Biography:
Samra Abouchacra has had extensive clinical and academic experience in Canada and UAE. She has Canadian & American Board certification in Internal Medicine & Nephrology and Masters in Science from the Toronto Institute of Medical Sciences. She is the founder and previous chairperson for Academic Affairs department and previous chairperson of Nephrology department at Tawam Hospital. She also served as medical director of Urology Kidney Disease Service Line Council for the Emirate of Abu Dhabi and has recently held the post of Director of Outpatient Services at Tawam and now Al Ain Hospital in preparation for commissioning of the new facility. She has been actively participating in teaching and research activities with numerous publications in peer review journals and among country investigators for the International Dialysis Outcomes and Practice Patterns Study (DOPPS). She has membership in national & international medical societies and is a fellow of American Society of Nephrology.
Abstract:
Obesity has become a global epidemic, which is rapidly spreading at phenomenal rates. The gravity of this “Globesity” epidemic goes beyond sheer numbers, as it is directly linked to numerous diseases that pose serious health risks and are responsible for escalating health care expenditures. Obesity is the single most important contributor to development of type 2 diabetes along with other metabolic disorders, all of which individually increase cardiovascular morbidity and mortality. Though the solution seems straightforward with weight reduction being the best cure, however, achieving and maintaining weight loss is extremely challenging. Diets have disappointingly had limited short term benefits with lack of sustainability and even rebound weight gain. In addition to their restrictive nature, there are even more complex personal behaviour and social factors affecting food ingestion that current day “diets” do not address. This lecture will highlight these shortcomings and explore dietary behaviour patterns promoting weight gain that may be critical in sabotaging weight loss efforts. Our GERG research group has undertaken a number of research initiatives including a multicentre survey aimed at understanding eating habits in overweight and obese individuals in our region. The published data will be shared for interactive discussion. Furthermore, a recently published novel eating behaviour modification concept called “Eat-ology” will be introduced. This intervention empowers individuals to identify their own specific “Eating Errors” and imparts techniques to convert them into “Eating Essentials.” In this way, Eat-ology not only circumvents many of the shortfalls of today’s “diets,” but through non-restrictive, simple and practical principles it may enable the transformation of one’s “way of eating” to support weight loss and its long term maintenance.
Samra Abouchacra
Al Ain Hospital, UAE
Title: Why diets fail? A role for “Eat-ology†as a disruptive weight loss methodology
Biography:
Samra Abouchacra has had extensive clinical and academic experience in Canada and UAE. She has Canadian & American Board certification in Internal Medicine & Nephrology and Masters in Science from the Toronto Institute of Medical Sciences. She is the founder and previous chairperson for Academic Affairs department and previous chairperson of Nephrology department at Tawam Hospital. She also served as medical director of Urology Kidney Disease Service Line Council for the Emirate of Abu Dhabi and has recently held the post of Director of Outpatient Services at Tawam and now Al Ain Hospital in preparation for commissioning of the new facility. She has been actively participating in teaching and research activities with numerous publications in peer review journals and among country investigators for the International Dialysis Outcomes and Practice Patterns Study (DOPPS). She has membership in national & international medical societies and is a fellow of American Society of Nephrology.
Abstract:
Obesity has become a global epidemic, which is rapidly spreading at phenomenal rates. The gravity of this “Globesity” epidemic goes beyond sheer numbers, as it is directly linked to numerous diseases that pose serious health risks and are responsible for escalating health care expenditures. Obesity is the single most important contributor to development of type 2 diabetes along with other metabolic disorders, all of which individually increase cardiovascular morbidity and mortality. Though the solution seems straightforward with weight reduction being the best cure, however, achieving and maintaining weight loss is extremely challenging. Diets have disappointingly had limited short term benefits with lack of sustainability and even rebound weight gain. In addition to their restrictive nature, there are even more complex personal behaviour and social factors affecting food ingestion that current day “diets” do not address. This lecture will highlight these shortcomings and explore dietary behaviour patterns promoting weight gain that may be critical in sabotaging weight loss efforts. Our GERG research group has undertaken a number of research initiatives including a multicentre survey aimed at understanding eating habits in overweight and obese individuals in our region. The published data will be shared for interactive discussion. Furthermore, a recently published novel eating behaviour modification concept called “Eat-ology” will be introduced. This intervention empowers individuals to identify their own specific “Eating Errors” and imparts techniques to convert them into “Eating Essentials.” In this way, Eat-ology not only circumvents many of the shortfalls of today’s “diets,” but through non-restrictive, simple and practical principles it may enable the transformation of one’s “way of eating” to support weight loss and its long term maintenance.