18^th Global Conference on Diabetes, Endocrinology and Primary Healthcare August 21-22, 2020 Geneva, Switzerland

Biography:

Francesco Lippi was graduated in Medicine, Surgery at the University of Pisa, Albo Pisa 1879/79, and specialization in Endocrinology at the University of Pisa July 1982 and specialization in Nuclear Medicine at the University of Florence July 1987. He has taught at the Institute of Clinical Methodology and the Institute of Endocrinology of the University of Pisa. From 1990 as a Professor of Endocrinology at the University Hospital of Pisa, he conducted the study (pahe se III) on effects of recombinant human TSH (rhTSH) adjuvant therapy in compassionate use program for patients with differentiated thyroid carcinoma.

Abstract:

Thyroid cancer is represented in most cases by differentiated thyroid carcinoma (DTC) (papillary or follicular), although the histological prevalence is papillary (90%). DTC is not particularly frequent, affecting only one in 25,000 people in Europe but increasing in the world, and has a higher incidence in women than in men (ratio 3-5:1). The DTC is asymptomatic, since in the great majority of cases the thyroid function appears normal. Secondary lymphadenopathy may rarely occur as a first event. Therefore the prevention, in particular the palpation and the ultrasound of the neck, becomes particularly important. A first cause is the area of origin (iodine deficiency). Another ascertained cause is the previous irradiation on the neck in pediatric age for benign pathologies. Other causes are the familiarity and genetic predisposition. It’s often the same patient who becomes aware of a swelling in the neck region. However, many of the nodules are so small in size that they are not discovered by the patient or the doctor, but require an adequate instrumentation (ultrasound). As soon as a thyroid nodule is discovered, it is advisable to carry out a specialist examination, blood test to measure serum FT3, FT4, TSH, anti-thyroglobulin antibodies and anti-thyroperoxidase (AbTg and AbTPO), and calcitonin (Ct). Following this phase, the neck ultrasound study follows. Often the ultrasound finding can already be suggestive of a suspicious nodule due to the presence of "spray" microcalcifications or to an incomplete halo sign or an increase in intra-nodular vascularity. The examination that still allows the diagnosis is the fine needle aspiration biopsy with cytological examination and international classification. In case of DTC, surgical therapy (total thyroidectomy) was generally followed by radioiodine therapy (RIT) which allows the elimination of residual thyroid tissues (ablation) and reduces the recurrences. Recently the new anatomopathological staging has reduced the RIT. Therefore, both papillary microcarcinoma and multifocal carcinoma, and papillary carcinoma with focal infiltration of the peri-thyroid soft tissues, are not treated with RIT if there are not different variants to the classical one. However, there are still authors who continue to treat patients (except microcarcinoma) still with RIT. This therapy can be performed both in conditions of hypothyroidism, or more recently without therapy withdrawal, but in euthyroid status after stimulation with recombinant human TSH. Moreover, the high serum TSH it’s the condition necessary for the thyroid cells stimulation, both for the production of thyroglobulin (Tg), and for the ability to concentrate radioiodine. The percentages of ablation and therefore of remission of the disease vary between 90 and 98% depending on the series published. RIT is followed by total body post-therapy scintigraphy that allows the visualization of radioactive iodine concentration in the body. About 10-15% of patients need an additional dose of radioiodine to complete the ablation of thyroid residues, while, in a small percentage of patients, for local or distant metastases or for detectable serum Tg levels

Biography:

Eduardo J Simoes is a Chair, Wesbury and HMI Alumni Distinguished Professor of the Department of Health Management and Informatics-University of Missouri School of Medicine. His Medical degree is from Faculdade de Medicina, Universidade de Pernambuco-Brazil (1981), Diploma and Master of Science degree from the University Of London School Of Hygiene Tropical Medicine (1987) and Master of Public Health degree from Emory University School of Public Health (1991). He is a Fellow of the American College of Epidemiology. He has published more than 135 papers and served as an Editorial Board Member of reputable journals

Abstract:

About more than 500 million adults worldwide now have diabetes mellitus, 90% of whom have type-2 diabetes (T2D). Successful glycemic control key to prevent and reduce complications of T2D and reduce death related to the disease. However, maintaining optimal glycemic control through ongoing monitoring and treatment can be costly and challenging. The development of innovative self-care strategies to improve diabetes management is necessary. Advances in health information technologies (HITs) aim to increase the support of effective and affordable health-care delivery and patient education. There is evidence that HIT approaches using mobile, computer, e-mail, and internet enhance chronic disease management. This research provides an overview of the HITs in use for T2D management. We synthesize the latest findings on HITs’ effect in reducing HbA1c and managing complications from cardiovascular diseases. We discuss the current research limitations and implications for future research. Finally, we present barriers to applications of HITs in T2D management and suggested steps to move forward

Biography:

Abstract:

Background:

Little is known about the prevalence of macrovascular disease in diabetic patients, in Rwanda.No any study done before on macrovascular disease. The aim of our study was to determine the prevalence of macrovascular disease and It associated risk factors, in rwandan diabetic patients.

Method:

This study was cross-sectional that was undertaken to evaluate the prevalence of macrovascular disease and associated risk factors among diabetic patients, at Kigali University Teaching Hospital and Butare University Teaching Hospital . We enrolled adult diabetic patients who attended the outpatient departments, from 2018-2019.

For every patient we did twelve lead electrocardiograms and It was done at initial enrollment time and interpreted using Manual Minnesota code (2) .Ankle Brachial Index was calculated using measurements from automated calf sphygmomanometer and every participant was clinically assessed , for the presence of cerebrovascular disease, basing on the WHO Monica criteria (3) .

Results: Features of macrovascular disease were found in 32 (21.7%) of the 147 patients: the most common being cerebrovascular disease with 15.6% ,followed by Peripheral Artery Disease 8.2% ,then coronary heart disease with a prevalence of 2%. The variables associated with cerebrovascular disease were: Gender, being male[p-value 0.02] and presence of coronary heart disease [p-value 0.014 ( 95%CI) ]

Peripheral vascular disease was associated with Duration of diabetes [ p-value 0.017 (95%CI)], tobacco smoking [p-value 0.02 ( 95%CI) ],elevated level of total cholesterol [ p-10 value 0.009( 95%CI)] and elevated level of LDL [ p-value 0.024( 95%CI)] while Coronary Heart Disease was significantly associated with elevated levels of triglyceride [ p-value0.027 ( 95%CI)] and the presence of cerebrovascular disease[ p-value0.014 ( 95%CI)].

CONCLUSION: Macrovascular disease is common in adult diabetic patients, in Rwanda. We need to elaborate a clear protocol on prevention and management of macrovascular disease,in diabetic patients.

Biography:

Piyarat Parklug. has completed her Doctor of Medicine at the age 24 years from Faculty of Medicine Vajira Hospital, Nuclear medicine radiology at the age of 28 years from Faculty of Medicine Chulalongkorn university. She is the director of nuclear medicine radiology unit at Vajira hospital, in charge of nuclear imaging diagnosis and treatment. She is the lecturer and  has experience in isotope treatment in patients with thyroid disease  over 10 years, has published 2 papers in journals, 1 chapter in national anual acedmic meeting

Abstract:

Biography:

Dr. Ma. Jean Capulong Linsao has completed her medical degree at University of the East, Ramon Magsaysay, Memorial, Medical Center, Inc, PH. She is also a graduate of Bachelor of Science in Community Nutrition at University of the Philippines. She is currently on her 3rd year of residency training in Internal Medicine at Bulacan Medical center, Philippines

Abstract:

Biography:

Abstract:

Diabetes Mellitus is a global epidemic, with 500 million people suffering globally in 2013. Patients cannot successfully manage their diabetic symptoms due to the lack of quality improvement (QI) of diabetic self-management education (DSME). In 2013, this number was 3 to 5 times higher in First Nations populations. The objective of this research is to facilitate better QI and DSME in Indigenous populations across the globe by creating a free, accredited course. This course will educate sustainable health promotion techniques needed for monitoring sugars, mental illness, treating common complications, medication management, and physical and nutritional therapy, to only name a few. Research on the succession will be analyzed in a Public Health practice-based research network (PBRNs) method with surveys, interviews, and statistical analysis on short-/long-term effectiveness from baseline tests. These will include: heart rate, blood pressure, mental health, medication, blood sugar levels >3 months, hyper-/hypo-glycemia, blood circulation, ankle brachial pressure test scores, kidney function, and macrovascular, retinopathy, dermatology and nerve damage complications. These tests will be completed in a small group of remote Indigenous communities in Quebec, Canada. It is hypothesized that this will improve public health efforts of patient self-management of diabetes and its associated symptoms. With this free, accredited, accessible online course to prepare health practitioners in DSME, better glycemic control, less hospital visits, decreased retinopathy, nephropathy, and neuropathy is expected.

Biography:

Abstract:

Carbamylation of LDL is a nonenzymatic posttranslational modification of LDL resulting from addition of urea-derived cyanate to either the N-terminus or ε-amino group of lysine residues in apolipoprotein B. The Carbamylated LDL (cLDL) has been recently shown to manifest all of the biological effects for relevant to atherosclerosis, including endothelial dysfunction, expression of adhesion molecules and vascular smooth muscle cell proliferation. In addition, cLDL binds to macrophage scavenger receptors inducing cholesterol accumulation, foam cell formation as well as enhanced oxidant generation. Despite the discovery of an alternative urea-independent myeloperoxidase-mediated mechanism for carbamylation, cLDL has been studied only in subjects with end stage renal disease. Elevated circulating and intraintimal cLDL levels have been associated with increased cardiovascular risk in those patients. However, other carbamylation products have been delineated as independent risk markers for cardiovascular disease even in the absence of uremia. Although diabetes mellitus is characterized by an increased atherosclerotic risk, chronic low grade inflammation and increased levels of myeloperoxidase, the data on cLDL in diabetes are scarce. Therefore, the present review reveals the main molecular mechanisms involved in the carbamylation of LDL in diabetes mellitus and briefly describes the atherogenic effects of cLDL. The possibility of using the high levels of cLDLs as a predictive tool for cardiovascular risk in diabetes-related pathologies is also discussed.

Biography:

Abstract:

India is the diabetes capital of the world with over 80 million diabetics (IDF). Current preventive diabetic footwear results in non-adherence as patients lament the quality, style and effectiveness of the footwear. We have studied how to design and make diabetic sandals using indigenous materials for the Indian consumer. The first phase of research involved personal interviews with 250 diabetic males between the age of 45-55 years spread across the country to understand the characteristics of ideal sandals for them after the consideration of geographical, cultural and climatic factors.  The second phase involved consulation with leading diabetologists and podiatrists to identify special concerns for the needs of diabetic feet in India. Then, by collaboration with footwear designers and component manufacturers in Italy, we designed a range of footwear that combines the needs of the caregiver and patient to thereby improve adherence. It was found that there is an increase in adherence of preventive diabetic footwear among Indian diabetic patients when given designs they are familiar with whilst also keeping costs between $30-$35. The framework for these designs are made by meeting the requirements laid down by caregivers.

Biography:

Zhaozhang SUN is a PhD candidate, awarded a 4-year full scholarship in Department of Culture, Media and Creative Industries, King's College London. She gained an Honorary Bachelor degree at Central South University and a Master's degree (Distinction) at University of Leeds. Before doing her PhD, Zhaozhang served as executive editor in Science and Technology Daily, which is the official newspaper of the Ministry of Science and Technology in PRC. She has published 14 papers and succeeded in finishing 4 research projects, one of which was the 2013 National Student Innovation Training Project.

Abstract:

E-Health is seen as the application of modern information and communication technology to advance or facilitate healthcare. People are more likely to search on social media (49%) than to see their doctors (11%) when they have healthcare problems. A special group of active social media users have appeared and started to gain attention in these years. They are not medical professionals but use social platforms to disseminate health information, create health awareness and provide health solutions to their target audiences. These so-called social media influencers have established a positive rapport with their audience. The main aim of this study is to investigate the diabetes narratives that have been presented by social media influencers (SMIs) because SMIs bring a new dimension for communicating health information with the potentially improving health outcomes. 10 social media influencers in the UK are defined in this study. Their existing diabetes narratives on social media and the impacts of those narratives on audiences’ health attitudes and behaviour are analysed through qualitative and quantitative methods, including frame (content-level) and discourse (language-level) features. Moreover, a comparative analysis of questionnaire data on audiences’ perception and perceived trustworthiness is conducted to investigate the effectiveness of SMIs in influencing their followers and non-followers.

Biography:

Dr.Abhishek Srivastava is an consultant endocrinologist working in R &R diabetes and thyroid care Centre.He completed his masters in  endocrinology at University of south wales at 2018.

Abstract:

Background and aims:  There is an increased prevalence of  hypogonadism in men with type 2 diabetes mellitus. The objective of this study was to estimate prevalence of hypogonadism  in adult patients with type 2 diabetes mellitus and examine relation of glycosylated haemoglobin, and body mass index with hypogonadism in these patients. 

Material and methods: In this cross sectional study, 50 adult male patients (30-60 years of age) with type 2 diabetes  were included.. Patients were divided into two groups; those with hypogonadism and without hypogonadism. Level of glycosylated hemoglobin between two groups  was compared. Similarly, comparison of BMI was done between two.

Results: The  mean (+SD) age of the patients in the study was 45.98 (+7.93) years. The mean (+SD) HBA1C of total study population was 8.31 (+1.70)% and  mean testosterone was 399.64 (+158.36) ng/dl respectively. The mean (+SD) level of HBA1C in patients with hypogonadism was 8.89 (+1.84)%  and with normal total testosterone level the mean (+SD) level of HBA1C was 7.84 (+1.86)%. The difference in mean glycosylated hemoglobin between two groups was not statistically significant. The mean (+SD) body mass index of patients with hypogonadism was 26.35 (+1.87) kg/m2 and without hypogonadism was 26.09 (+2.53). There was no significant difference in the BMI of both groups.

Conclusion: Patients with type 2 diabetes mellitus showed high prevalence of hypogonadism. Level of glycosylated hemoglobin was  not significantly high in patients with hypogonadism.

Biography:

Dr. Ivan Domuschiev was graduated in 1986 the Medical Univercity in Plovdiv city with fully excellent marks as promotor of the course (speciality“medicine“). He was defended a dissertation with a conference on the scientific degree” Philosophy Doctor in Medicine“(Ph.D.) in the field of the endocrinology (diabetology). He was long time Assistant-Professor in the internal diseases and endocrinology as well as he leaded clinical exercises in postgraduated teaching. He worked as Assistant-Professor at the Clinic of Endocrinology – Medical University in Plovdiv, Clinic of Endocrinology.His scientific publications are in the field of endocrinology, diabetology, cardiology and other areas of the internal medicine, neurovegetology, phytotherapy and also anti-aging medicine. He has own scientific investigations in the field of the heart rate variability (HRV) in patients with various diseases.

Abstract:

Background: The problem Pulse Rate Variability (PRV) in  type  2  diabetes  and  increased  body  mass  index  has  not  been  studied  enough. Type  2  diabetes  affects      the  peripheral  vasculature  leading  to  coronary,  cerebral  and  peripheral  vascular  disease associated with  oxidative  stress  and  inflammatory  processes.  Similarly increased body weight also changes oxidative stress  and  inflammation  that  may adversely affect diabetes disease progression.

Methods: The Heart  Rhythm  Scanner  Special  Edition  Version  1  (Biocom  Technologies,  USA)  was  used  for   PPG   (Photoplethysmography)   recording   and   PRV analysis.

Results: Our study found that  short-term  measurement  of  PRY  shows  some  statistically   significant   differences   using   multifactorial   analysis   of   type   2   diabetes with overweight and a healthy control group with normal weight. Short- term measurements of PRV can be used  as  an  alternative  method  for  HRV.  PPG-method can  be  used   as   preliminary   screening   tool   for   large   populations   with  increased  risk  of  heart  problems.  This is  because  the  PPG  method  is  simple    to use and takes much less time