19^th International Conference on Diabetes, Nutrition, Obesity and Eating Disorders August 21-22, 2020 Florence, Italy

Professor Ana Dâmaso has completed her PhD in Nutrition Sciences at the age of 35 years from Paulista Medicine School at the Federal University of São Paulo; and postdoctoral studies in Pediatrics Sciences from the same University. She is Brazilian Researcher of National Council on Scientific and Technological Development. She has published more than 100 papers in reputed journals and has been serving as an editorial board member of  World Obesity Federation.

Introduction: metabolic syndrome is a constellation of altered parameters that coexist with obesity increasing risks for cardiovascular disease.

Objective: To evaluate 1) the effects of the clinical multicomponent therapy in the prevalence of metabolic syndrome; and 2) if the leptin and adiponectin can modulate its response in women with obesity.

Methods: Interdisciplinary therapy consisted of follow-up with an endocrinologist, nutritionist, and exercise physiologist, associated with health education by web-based weekly videos about exercise and nutrition to promote lifestyle changes (# 12semanas®) and support through Facebook®, Instagram® and WhatsApp®. This study was approved by the Research Ethics Committee. Women with obesity (n = 32), aged 31.06 ± 4.70 years and BMI of 34.01 ± 4.00 kg/m² were selected. Body composition by electric bioimpedance and adiponectin, leptin by ELISA were performed. The metabolic syndrome screening was made by IDF criteria.

Results: At the beginning of therapy 21.8% of women with obesity present metabolic syndrome (MS) diagnosis wich was reduced to 3%. In the delta comparison, MS group presented higher values for body weight, waist circumference, body fat, total cholesterol, and reduced HDL-c. Improvements were finding in body composition and lipid profile in both analysed groups. In the MS group it were observed a reduction in the leptin concentration. Delta comparison finding a positive correlation between leptin/adiponectin ratio with waist circumference and HOMA-AD.

Conclusion: Clinical approach associated with health education was effective in reducing the MS prevalence mediated by leptin and adiponectin avoid the development of cardiovascular disease in women with obesity.

KeyWords: Obesity, Metabolic syndrome, Exercise, Diet therapy, Social networking

 

Mitra Kazemi Jahromi is an Endocrinologist, Assistant Professor of Hormozgan University of Medical Sciences, Bandar Abbas, Iran . Education: General Practice: Shiraz University of Medical Sciences, Shiraz, Iran.

Specialty of Internal Medicine: Tehran University of Medical Sciences, Tehran, Iran, 2011

Sub specialty of Endocrinology and Metabolism: Shahid Beheshti University of Medical Sciences, Research institute for endocrine sciences, Tehran, Iran, 2018.

I have published some national and international papers in esteemed journals about internal medicine and now working in Clinical Research Center and Endocrine Research Center of Hormozgan University of Medical Sciences with more focus on diabetic patients. I have appeared many national and international symposiums as a speaker.

Background: Patients with type II diabetes are at high risk of dyslipidemia, and subsequently, cardiovascular diseases. The present study investigates the relationship between glycosylated hemoglobin and lipid profile, and its effect as a predictive indicator of dyslipidemia in type II diabetes.

Method: The present cross-sectional study enrolled 802 patients with type II diabetes. Glycosylated hemoglobin was divided into two groups (<8% and ≥8%).GFR at two levels (>60% and ≤60%) was measured using two different techniques (EPI and MDRD). Then, the relationship of lipid profile with different levels of HbA1C and GFR was separately determined.

Results: In the present study, 74% of those with HbA1C≤8% and 71% of those with HbA1C>8% were female. Cholesterol, Triglyceride and LDL were significantly higher in patients with HbA1C>8% compared to those with HbA1C≤8 %( P value<0.005, 0.046 and 0.005, respectively). The relationship with HDL was not significant. Moreover, analysis of data at two levels of GFR showed a significant difference in patients with GFR≥60 only in terms of Triglyceride. This relationship was significant using both EPI and MDRD methods (P value=o.o11 and 0.017 respectively).

Conclusion: Glycosylated hemoglobin can be used as a predictor of dyslipidemia in patients with type II diabetes, and its subsequent diagnosis and treatment, and thus prevention of cardiovascular diseases.      

 

Dr Melanie Burkhardt is a clinical psychologist with 16 years of practice experience working with people living with chronic health conditions. She has a special interest in the care of high-risk patients living with Type 1 and Type 2 diabetes. Melanie works within a multidisciplinary team, in a tertiary diabetes center based in Western Australia. Her research interests are in the translation, development and evaluation of behavioural interventions to improve diabetes self-care and reduce psychological distress in high-risk patient groups. Melanie provides education and consultation regarding the psychological care of people living with diabetes at a local and national level.

Adults living with type 1 diabetes (T1D) can find the condition challenging to manage, resulting in many struggling with suboptimal glycaemic control, and thus increasing their risk of acute and long-term health problems. Psychological distress can present additional barriers to improving self-care. Standard diabetes care includes medical, educational and technological interventions, which are important however, for a significant proportion of patients, these may not be sufficient. We describe a brief multi-component behavioural intervention based on well-established principles of complex learning and behaviour. The intervention aims to increase frequency of valued self-care activities and reduce avoidance coping. The Enhanced Self-Care for Diabetes (ESD) intervention components can be presented in either individual or group format. ESD is personalized to each individual’s diabetes self-care goals, self-management skills and current circumstances. Program components are pragmatic and straightforward by design so that the individuals can self-manage behaviour change for longer-term benefit. We present group evaluation data with n=66 participants attending our outpatient tertiary diabetes centre. Evaluation measures include glycaemic control, frequency of diabetes self-care activities, diabetes-related distress, hypoglycemia worry, diabetes-related eating problems, and quality of life. Participant satisfaction with treatment outcomes and acceptability of the methods used to address diabetes-related concerns will be presented. Characteristics of the program completers and non-completers, and potential mediators and moderators of intervention outcomes will be discussed. Illustrative examples will be used to highlight the reasons underlying diabetes-related distress, and how facilitating incremental increases in key self-care behaviours can lead to improving clinical outcomes in a high-risk population with diabetes.

Elia Garcia Caldini completed her PhD in Experimental and Comparative Pathology at University of São Paulo (Brazil) and postdoctoral studies from Bologna University (Italy). She is the Professor at Pathology Department and director of the Medical Research Laboratory for Cell Biology at University of São Paulo School of Medicine. She has published more than 70 papers in journals with a strong editorial policy.

Diets high in antioxidant substances (polyphenols) may reduce the risk of cardiovascular events. Low consumption of fruits and vegetables is involved in oxidative stress, hypertension and insulin resistance. Although the consumption of fresh fruit or juice is the best way to acquire its nutritional components, the use of capsules containing fruit extracts has the advantage of being easily consumed and lasting longer. Therefore, studies are needed to support antioxidant supplementation in the form of encapsulated fruit extracts and to verify if the protective properties of these fruits remain after the processing that generates the extracts. Thus, the objectives of this study are: 1) To determine the phenolic content and antioxidant capacity of cranberry, blueberry and pomegranate extracts; 2) Perform evaluation of oxidative stress markers, markers of inflammatory activity, together with hemodynamic assessment. For this, a placebo-controlled clinical trial was conducted with hypertensive and normotensive subjects who received the fruit extract capsules (blueberry, cranberry and pomegranate) for 4 weeks. Hemodynamic, inflammatory mediators, insulin resistance, and plasma antioxidant activity evaluations were performed. Biochemical analysis of fruit extracts showed that the antioxidant activity of phenolic components remains in the capsules. The HOMA-IR index, that discloses insulin resistance, decreased significantly after capsule consumption. Although there were no hemodynamic changes, there was a decrease in lipid peroxidation after capsule consumption and an increase in catalase activity. The results of this study suggest that supplementation with cranberry, blueberry and pomegranate capsules can reverse oxidative damage and reduce insulin resistance in hypertensive patients.

Manisha Sapkota has completed her Bachelor at the age of 22 years from Manmohan Memorial Institute of Health Sciences. Her manuscript which was submitted to Journal of Multidisciplinary Healthcare has moved to status 'First Report Returned. She is Medical Laboratory Technologist at South Asian Polyclinic and Diagnostic Center.

Objective:

Diabetes is a chronic metabolic disease which is growing at worrying rate in developing country like Nepal. . It is prevalent in children, adolescent and young adults due to increase in risk factors such as over feeding, physical inactivity, obesity. Therefore, the aim of this study was to assess diabetes risk score among young individuals.

Methods: Across sectional study was conducted among students of age group (18to 25 years) studying at Manmohan Memorial Institute of Health Sciences and Central Institute of Science and Technology. All the socio-demographic data, anthropometric measurements, lifestyle and dietary habits were recorded by using standard questionnaire. Fasting plasma glucose and lipid profile were estimated by using standard manufacturer’s guideline. The Diabetes risk score was calculated by The Finnish Diabetes Risk Score (FINDRISC tool). Association between cardio-metabolic risk factors and diabetes risk score was established by ANOVA test.

Results: Among total 825 students, 739 (89.6%) were recruited for the study with complete questionnaire, anthropometric measurement and fasting blood sample. Median age of the study population was 20 years. Among total study population, 553 (74.80%) were under low risk (FINDRISC<7), 164 (22.18%) were at slightly elevated risk (FINDRISC 7-11), 15 (2.02%) were at moderate risk (FINDRISC 12-14) and 7 (1.01%) were at high risk of diabetes. BMI, TC and LDL-C were higher at significant level (p<0.001) with increasing diabetes risk score in our study population.

Conclusion: Risk factors for diabetes were common among young adults. Early assessment of diabetes risk in young may provide insights for preventive and control plan for risk population.

Introduction: Chronic kidney disease (CKD) has become a global public health threat. The irreversible nature of the disease, its association with significant morbidity and mortality as well as the cost of renal replacement therapy leads to a large burden for health care providers, particularly in developing countries like Egypt.

 

Objective: to find a non-invasive method to evaluate association of serum visfatin with chronic kidney disease secondary to diabetic nephropathy and compare to patients with chronic kidney disease secondary to other causes.

 

Methods: Ninety individuals including 30 healthy controls and 60 patients of CKD were included in this study. Patients with CKD were further grouped based on etiology of CKD into 30 diabetic patients and 30 non-diabetic patients. Patients with type 1 diabetes mellitus, urinary tract infection, urolithiasis, liver cirrhosis, stroke, ischemic heart disease, and rheumatoid arthritis were excluded. Measurement of serum visfatin was done through ELISA Kit (Elabscience pharmaceuticals).

 

Results: Visfatin concentration was significantly high in patients with CKD compared to controls (p < 0 .001). No significant difference in Visfatin concentrations between patients of CKD with and without diabetes was detected (p > 0.05). Visfatin concentration was significantly high in patients with CKD stage 2 compared to CKD stage 1 (p < 0 .001). Conclusion: The present study confirms the association of visfatin with CKD, however further studies at molecular level to check its expression within renal tissue may clarify its definitive role in CKD.

 

Keywords : Visfatin, Chronic Kidney Disease, Diabetes Mellitus

Omentin-1 is an anti inflammatory adipokine expressed and secreted from

visceral adipose tissue, which plays roles in glucose homeostasis, lipid metabolism, insulin resistance and diabetes. The aim of our study was to evaluate serum omentin-1 levels in type 2 diabetic women and its relation with metabolic syndrome (MS) related risk parameters. Thirty-six newly diagnosed type 2 diabetic women, fifty-eight type 2 diabetic women not fulfilling the criteria of MS, fifty type 2 diabetic women with MS, and forty healthy control women were enrolled in this study. The levels of fasting and 2-hour postprandial blood glucose, lipid profile, fasting serum levels of insulin, omentin-1 and HbA1c were measured. HOMA-IR was calculated. We found significant decrease in serum omentin-1 levels in type 2 diabetes patients with mean ±â€¯SD (27.2± 7.1 ng/L) compared to controls (48.8± 14.5  ng/L) (P < 0.001) and in diabetic patients with MS compared to newly diagnosed diabetics and diabetic patients without MS (P=0.001and 0.006 respectively). We also found significant negative correlations between serum omentin-1 and (waist circumference, BMI, cholesterol, triglycerides, fasting insulin, HOMA-IR), r = (-0.57, -0.36, -0.52, -0.38, -0.42, -0.32) respectively (P < 0.001). The best cut off point of serum omentin-1 was 36.1  ng/L to differentiate cases from controls using ROC curve analysis with 88.9% sensitivity and 100% specificity, and was 27.05 ng/L to differentiate cases with MS from those without MS, with 79.2% sensitivity and 70.2% specificity. Our study suggests that decreased omentin-1 can contribute to development of insulin resistance and its associated metabolic risk factors in type 2 diabetic women.

Introduction:The reversion of diabetes and the treatment of long-term obesity are difficult challenges. The failure mechanisms of rapid weight loss are mainly related to the wasting of lean mass. This single-arm study aims to evaluate the effects of a very low-calorie ketogenic diet (VLCKD) on body composition and resting energy expenditure (REE) in the short term reversal of diabetes mellitus Type 2 (DMT2).

Results:  The main findings were the saving of lean mass, the reduction of abdominal fat mass, restored metabolic flexibility, the maintenance of resting energy expenditure, and the reversion of diabetes.