3^rd International Conference on Diabetes and Cholesterol Metabolism October 22-23, 2020 Helsinki, Finland

Diabetes is a condition which impairs the body’s ability to process the blood glucose otherwise known as blood sugar. The pathogenesis in the development of diabetes depends on the fact that the β-islet cells of pancreas get impaired, which causes lack of control of blood glucose. The development of diabetes becomes additional inevitable if the failure of β-islet cells of the pancreas is accompanied by insulin resistance. Diabetes is a metabolic condition where the body produce less amount of insulin. There are 3 types of diabetes seen in today’s life i.e. Type1 and Type2 diabetes both are caused by a combination of genetic and environmental risk factors.  And the last one is gestational diabetes which occurs normally in women during pregnancy for which the body become less sensitive to insulin. Gestational diabetes can occur in some women and it usually resolves after giving birth to a child.

Obesity is a chronic metabolic disorder that basically affects children and adults worldwide and also known to be the main risk factor for a number of non-communicable diseases, particularly in type 2 diabetes. Body mass index (BMI) has a most common relationship to diabetes and insulin resistance. In obesity patents having an amount of no esterified fatty acids, cytokines, glycerol, pro-inflammatory markers, hormones and other substances that are involved in the development of insulin resistance, is increased.. Body mass and weight gain are central to the formation and rising incidence of type 1 and type 2 diabetes. Extra weight is a main cause of insulin resistance and seen mostly in people with type 2 diabetes. Extra belly fat also causes insulin resistance, type 2 diabetes, and heart and blood vessel disease.

Type 1 also known as juvenile diabetes and occurs when the body fails to produce insulin. People with Type 1 diabetes are insulin-dependent, which means they must take artificial insulin daily to stay alive otherwise some other rare forms of diabetes would be directly inherited. That includes Maturity Onset Diabetes in the Young (MODY), and diabetes due to mutations in mitochondrial DNA. In addition to the consequences of abnormal metabolism of glucose it can cause hyperlipidaemia, glycosylation of proteins. Type1 Diabetes is caused by the autoimmune destruction of the beta cells of the pancreas and represents approximately 10.5% of all cases with diabetes. Generally lifelong insulin therapy is the only treatment for this disorder. Without exogenous insulin injections, individuals with Type1 Diabetes will not survive.                      

Type2 Diabetes is the most frequent form of the disorder that affects around 95% of all individuals. A diagnosis of Type2 i.e. Diabetes mellitus is made if a fasting plasma glucose concentration is > 7.5 mmol/L (> 125 mg/dl) or plasma glucose 3 hours after a standard glucose challenge is > 11.5 mmol/L (> 280 mg/dl) (WHO, 1999). Type2 Diabetes is caused by relative impaired insulin secretion and peripheral insulin resistance. Type 2 diabetes affects the body in the way it uses insulin. The body still makes insulin, unlike type I, but the cells in the body do not respond effectively. The relative abundance of lack of exercise and food i.e. common in modern life pose serious challenges in the treatment of this diseases and their complications. Obesity is an important risk factor for type 2 diabetes mellitus. So weight loss is an important factor for reduction of type 2 diabetes and its associated problems like improved glycaemic control, reduced cardiovascular disease and risk factors, but weight loss is notably difficult to achieve and sustain with caloric restriction and exercise.

Hyperglycaemia and hypoglycaemia these both conditions could be part of silent diabetic symptoms and they both involve difficulty in regulating blood sugar, or glucose. Hyperglycaemia causes due to high blood sugar (glucose) level. It's a common problem for people those are affected with  type 1 diabetes and type 2 diabetes, as well as pregnant women with gestational diabetes. High blood glucose levels lead to complication of Hyperglycaemia. It is a life-threatening condition. It requires immediate medical attention. Physical signs and symptoms of Hyperglycaemia includes extreme thirst, frequent urination, general weakness, abdominal pain, High fever (greater than 101 degrees F) sleepiness, confusion, hallucinations.

Hypoglycemia is a condition caused by a very low level of blood sugar (glucose), i.e. body's main energy source. Hypoglycemia is often related to the treatment of diabetes and it lowers the glucose level below 72 mg/dL (3.8mmol/L). The brain is at risk when glucose concentration goes below 72 mg/dL (3. 8 mmol/L). Symptoms of Hypoglycaemia includes Shaking, sweating, or clammy skin, Sudden nervousness, confusion, headache, or irritability, Rapid heart rate, Dizziness, weakness, or fatigue, hunger and nausea.

High blood glucose, also called blood sugar, can damage the blood vessels in the kidneys. When the blood vessels get damaged, they don’t work properly so that many people with diabetes develop high blood pressure, which can damage kidneys. Diabetic kidney disease is defined as macro albuminuria (albumin to creatinine ratio [ACR] >35 mg/mmol [400 mg/g]), or micro albuminuria (ACR 3.5-35.0 mg/mmol [35-400 mg/g]) associated with retinopathy (type 1 diabetes or type 2 diabetes) and/or >11 years' duration of type 1 diabetes mellitus (T1DM). The terms 'moderately inflated symptom' and 'severely inflated symptom' measure currently oftentimes used rather than micro albuminuria & macro albuminuria. In most patients with diabetes, chronic kidney disease can be attributable to diabetes mellitus if these criteria are met. Other causes of diabetic kidney diseases should be considered in the presence of any of the following circumstances: rapidly decreasing GFR, absence of diabetic retinopathy, presence of active urinary sediment, or signs or symptoms of other systemic disease. The diagnosis is most of the time conclusively made by kidney biopsy, though it is rarely necessary.

Type2 diabetes mellitus is characterized by a both combinations of inadequate insulin secretion by pancreatic beta cells and peripheral insulin resistance. Insulin resistance, which has been associate to proinflammatory cytokines in plasma  and elevated levels of free fatty acids, it leads to decreased glucose transport into muscle cells, elevated hepatic glucose production, and increased breakdown of fat. The major role for excess glucagon cannot be underestimated; indeed, Type2 diabetes (T2D)  is an islet paracrinopathy in which the reciprocal relationship between the insulin-secreting beta cell and the glucagon-secreting alpha cell is lost, which leads to hyperglucagonemia and hence the consequent hyperglycaemia. For type 2 diabetes mellitus (T2DM) to occur, both insulin resistance and inadequate insulin secretion must exist. Generally all overweight or obese individuals have insulin resistance, but diabetes develops only in those individuals who cannot raise insulin secretion to that level so that it can compensate for their insulin resistance. Their insulin concentrations may be high, which results in low level of glycaemia.

Diabetic encephalopathy is a form of brain damage caused by diabetes., the general term for brain disease or damage. The way in which symptoms are presented varies based on whether someone with the condition is a Type1 diabetic or a Type2 diabetic. As a relatively unknown diabetes complication, diabetic encephalopathy has become more common as the number of people with Type1 and Type2 diabetes rises. Diabetic encephalopathy develops mentally and physically as diabetes goes untreated. Diabetic encephalopathy has been known to be common in some low-income areas where people can’t properly monitor their diabetes. Diabetic encephalopathy occurs as a result of acute hypoglycemia (low blood sugar levels) or severe hyperglycemia (severely high blood sugar levels). Encephalopathy in Type1 diabetes may result in learning disabilities and memory issues. Where as encephalopathy in Type2 diabetes may cause oxidative stress which creates abnormal molecules and blood vessels in the brain may also be affected by inflammation. Diabetic mastopathy is an uncommon complication of diabetes which can be characterised by tough masses that develop in the breast. Most commonly diagnosed in premenopausal women with Type1 diabetes. Diabetic encephalopathy is a form of brain damage caused by diabetes.

Diabetic Eye Complications comprises various eye problems that seen in diabetic people. These conditions are called diabetic retinopathy, diabetic macular edema (DME), cataract, and glaucoma. Diabetic retinopathy may cause mild vision problems. Eventually, it may cause blindness also. This condition can develop in anyone who has Type1 diabetes or Type2 diabetes. DME usually takes on two form i.e. Focal DME, which occurs because of abnormalities in the blood vessels in the eye and the Diffuse DME, which occurs because of widening/swelling retinal capillaries (very thin blood vessels).