4^th International Conference on Diabetes and Cholesterol Metabolism December 17-17, 2021 London, UK

Metabolism is the set of physical and chemical processes that takes place in an organism by which its material substance is produced, maintained, and destroyed, and by which energy is made available. Metabolism aids in the conversion of food to energy and run cellular processes; to build proteins, lipids, nucleic acids, and some carbohydrates; and the elimination of metabolic wastes. When the metabolism process fails to function properly it leads to metabolic disorders. The body needs amino acids and proteins to perform all functions. Metabolic disorders can occur due to abnormal chemical reactions that help metabolic process, nutrition deficiency, loss of an enzyme that is essential for metabolic process, or due to disease in liver, pancreas, and endocrine glands. Few classes of metabolic disorders are:

Cholesterol is an important lipid for mammalian cells and its homeostasis is strongly regulated. Any disturbance in homeostasis of cellular cholesterol leads to atherosclerosis and cardiovascular diseases. Endoplasmic reticulum (ER) plays an important role in maintaining cholesterol metabolism and homeostasis. High levels of glucose, fat, and cholesterol in the blood can lead to atherosclerosis, vessel dysfunction and blocked blood flow, the principal mechanism for cardiovascular diseases (CVDs). CVDs comprise stroke, heart attack and peripheral arterial disease (PAD) among others.  A high level of cholesterol in blood leads to Hypercholesterolemia and people with hypercholesterolemia have more chances of developing coronary artery disease.  Presence of very low levels of cholesterol in blood leads to hypocholesterolemia. This can be due to decreased liver function, malnutrition, hyperthyroidism, intestinal loss, Addison’s-like disease

Abnormal lipid profiles are shown by patients with polygenic disorders as hormone regulates several steps of lipid metabolism. Patients suffering with Type1 diabetes show adequate glycaemic control but do not have quantitative lipoprotein abnormalities. Studies shows that patients with both type 1 and type 2diabetes have consistent weight gain, exhibited more lipid profiles in Type2 diabetes (T2D). Dyslipidaemia in Type2 diabetes has shown many strictly linked abnormalities.

Metabolic syndrome is a mixture of many risk factors which comprises hyperglycemia, high blood pressure, abnormal cholesterol levels and excess body fat around the waist. These factors double the risk of heart disease, stroke, and diabetes.  This disorder is also known by other terms like Syndrome X, dysmetabolic syndrome and insulin resistance syndrome. Insulin resistance, metabolic syndrome and prediabetes have overlying features and are closely related to one another. Most of the disorders accompanied with metabolic syndrome have no symptoms, even though it is closely connected to insulin resistance, overweight or obesity and inactivity. Metabolic syndrome can be prevented or reversed by adopting a healthy lifestyle, including regular exercise, losing weight, healthy diet, stopping smoking, and alcohol.

Metabolic brain disorders are deleterious metabolic disorders that are usually associated with acute and severe illness. Although the metabolic brain disorders are very rare, acquired or inborn metabolic diseases leads to brain dysfunction or damage. These are classified as primary and secondary metabolic disorders that adversely affect cerebral function. These disorders are categorized as amino acid metabolism disorders, organic acid disorders, primary lactic acidosis, or fatty acid oxidation disorders.

Many metabolic disorders affect liver and causes chronic liver diseases, leading to cirrhosis and liver cancer. The most common metabolic liver disease are hereditary hemochromatosis, Alpha-I antitrypsin deficiency (AATD), and Wilson Disease. Metabolic liver diseases might be due to excess iron load or copper load, or some rare genetic conditions that causes emphysema in adults or liver disease at any age. Treatment for metabolic liver diseases include:

Reproductive endocrinology and infertility is a part of gynecology and obstetrics which educates physicians of reproductive medicine about hormonal functioning as it connects to reproduction as well as the issue of infertility. The specialists in the field of REI focus on treating infertility, while reproductive endocrinologists are trained to test and treat hormonal dysfunctions in females and males. Reproductive surgery physician are even given training to operate on anatomical disorders that affect fertility.

Pediatric metabolic disorders are observed in children when their body is not properly processing the nutrients like sugars, proteins, or fats. The metabolic disorders seen in children can be genetic that is passed down in families. If the metabolic disorders are seen in older children then it is often due to obesity. Children with metabolic disorders are at greater risk to develop diseases such as Type 2 diabetes and heart disease.

It was estimated that 460 million people had diabetes and resulted in about 4.2 million deaths worldwide in the year 2019. Diabetes mellitus is carbohydrate metabolism disorder characterized by high blood glucose levels (hyperglycemia). There are 2 types of diabetes mellitus one resulting from inadequate production of the insulin hormone (type 1 diabetes), and other due to an ineffective response of cells to insulin (type 2 diabetes). If patient is left untreated, diabetes can lead to many health complications. Type 1 diabetes can be managed by injections of insulin, whereas, type 2 diabetes (most common type of diabetes), can be managed by following a healthy life style. Some serious complications include cardiovascular disease, stroke, chronic kidney disease, foot ulcers, nerve and eye damage and cognitive impairment.

Gestational diabetes is a type of diabetes seen in pregnant women due to high blood glucose levels in their body. This is because of the body’s inability to use up all the insulin needed to support the demands of the pregnancy.  Even though pregnant women experience gestational diabetes only 7% women face complications due to it. It increases risk of type 2 diabetes. High glucose levels in blood is not only a concern for mothers health, but it also leads to long term complication in new born if left untreated. Gestational Diabetes can be treated by

Diabetic retinopathy is an eye complication seen in people suffering from diabetes. This is observed when high blood sugar levels damage the blood vessels in the retina, causing swelling, leakage, and blood flow, resulting in loss of vision. Various surgical procedures for glaucoma are Argon laser trabeculoplasty (ALT), Selective laser trabeculoplasty (SLT), Laser peripheral iridotomy (LPI), Cyclophotocoagulation, Trabeculectomy, Drainage implant surgery, and Electrocautery. Various diabetic retinopathy surgical procedures are Photocoagulation, Panretinal photocoagulation, Vitrectomy, Injecting medicine into the eye. Diabetic eye complications can be identified by symptoms like

Patients suffering with diabetes are more susceptible for oral health complications than normal people whose blood glucose levels are in control. Diabetes is also a reason for many dental and gum diseases like gingivitis, periodontitis (mild and severe), fungal infections, dry mouth, loose teeth and so on. Balancing Blood glucose levels and maintaining proper oral and dental hygiene helps to reduce such oral complications.

Inherited Metabolic Errors are a diverse group of disorders that are genetically transmitted, typically in an autosomal recessive fashion, may occur as the result of spontaneous mutations. These diseases ultimately results to defects in the biochemical pathways involved in either the break-down or storage of carbohydrates, fatty acids, and proteins. 

Obesity is a chronic metabolic disorder that affects both children and adults globally. It is the major risk factor for a number of non-communicable diseases, mainly in type 2 diabetes. Obese people with impaired glucose tolerance (IGT) or impaired fasting glucose (IFG) should take care of their body weight to prevent further progression to diabetes.  Patients older than 45 years are screened for body mass index (BMI) to determine diabetes.

Endocrine oncology is a medical speciality that deals with hormone producing tumors, i.e. a combination of endocrinology and oncology. Neuroendocrine tumors are neoplasms that arise from endocrine and nervous cells. Most commonly seen tumors are carcinoid tumors that affect the intestine, but there are other types of cancers that affect pancreas, lung and the rest of the body. Even though there are many types of  NETs, all are treated as a group of tissue, as the cells of these neoplasms share common features like looking similar,  some special secretory granules, and often produce biogenic amines and polypeptide hormones.

People with diabetes are more likely to develop congenital heart disease and have a greater chance to have heart attack or a stroke.  Person with diabetes can protect their heart and health by managing blood glucose, blood pressure and cholesterol. High blood sugar in body eventually damages blood vessels and the nerves that control heart.  Diabetic patients have more chances to develop heart diseases.

Biochemical Genetics involves testing and determining inherited metabolic disease, monitoring of treating, and distinguishing heterozygous carriers from non-carriers by metabolite and enzymatic analysis of physiological fluids and tissues in patients. Hereditary metabolic disorders are tested by extremely specialized and fragmented activity, and mostly by research-oriented scientists.

Stem cell-derived pancreatic islet transplantation is a β-cell replacement therapy which involves transplantation of isolated islets from donor pancreas to receiver, for the treatment of insulin-deficient diabetes. Once they are transplanted, the islets start producing insulin and actively regulate blood glucose levels. It was observed that 70% of patients who received an islet cell transplant no longer needs insulin after one year and may not need it in the future. Some of the benefits of Islet Transplantation are

Cardiometabolic syndrome (CMS) is a group of metabolic dysfunctions that are mainly characterized by insulin resistance, impaired glucose tolerance, dyslipidaemia, hypertension, and central adiposity. World Health Organization and the American Society of Endocrinology now recognized CMS as a disease entity. Patients with CMS have more chances to die from coronary heart disease, heart attack or stroke. Cardio metabolic programs and therapeutic strategies that combine diet and exercise prescriptions help to reduce cardiometabolic risk factors.  Treatment strategies include

Prevention and management metabolic syndrome requires addressing several conditions. One can improve overall cardiovascular health and conditions that lead to metabolic syndrome by eating healthier, being physically active, and losing weight.

Management of metabolic syndrome mainly involves changing lifestyle, changing diet and exercise habits. Evidences show that following proper diet, exercise, and pharmacologic interventions might inhibit the progression of metabolic syndrome to diabetes mellitus.

Medicinal Plants serves as effective agents in treatment of metabolic disorders as they have biologically active substances. There are more than 1200 medicinal plants that are useful to treat diabetes and also target other risk factors accompanied with metabolic syndrome, including hypercholesterolemia and hypertension. Herbal medicines are useful in reducing waist circumference, blood glucose, blood lipids, and blood pressure. Each metabolic risk factor is associated with one another, and collectively increases the risk to promote atherosclerotic cardiovascular illness.

The term Diabetes technology is used to refer the hardware, devices, and software that diabetic people can use to help manage blood glucose levels, reduce the risk of diabetes and improve quality of life. Recent technology has extended to include hybrid devices that monitor glucose and deliver insulin. If Diabetes technology used appropriately, it can improve the quality of life and health of people with diabetes.  But, the complexity and quick change of the diabetes technology can also become a barrier to patient and provider implementation.

Patients with type 1 or type 2diabetes should be more cautious about their health. Diabetic patients may experience more complications if they get affected with corona virus. Few reports have shown that about 25% of people who were affected with coronavirus had diabetes. High blood sugar level in the body of diabetic patients weakens the immune system and makes body more vulnerable to coronavirus and can ultimately lead to death. High blood sugar levels weaken the immune system and make it less possible to fight off infections. Corona virus can even increase the risk for diabetes complications like diabetic ketoacidosis (DKA). Therefore if a diabetic patient gets affected by new coronavirus they should check their blood sugar levels more often than usual, take more fluids, and drink water often. To reduce your chance of getting infected:

Education on diabetes is an integral component of the diabetes management and care as diabetes needs day-to-day knowledge on nutrition, exercise, monitoring, and medication.  A healthy diet is required for management of diabetes. The target of patient education is to increase their knowledge, develop confidence in them, assisting them to take control of their own condition and integrate effective self-management into their daily lives. Properly planned education can have an effect on health outcomes and can significantly improve quality of life.