28^th World Congress on Diabetes, Obesity & Heart August 20-21, 2018 Tokyo, Japan

Biography:

Chacón-Lozsán F, polyglot, graduated as Medical Doctor in UCLA (Venezuela) 2014, Graduated in Critical Care Medicine -"Universidad Central de Venezuela”, University Central Hospital-Caracas, and Master degree Student in Higher Education at the International Iberoamerican University. Scientific activity since 2007 with Rafael Bonfante-Cabarcas MD PhD on Neurochemical and Molecular Pharmacology Laboratory in behavior,cardiac molecular electrophysiopathology and Chaga’s Disease with training in statistics, critical reading and redaction of scientific production, molecular electrophysiology, biochemistry and bioterious management. Student fellow in Cardiology (2010-2012) with Bartolomé Finizola MD PhD FACC in the Cardiovascular Association ASCARDIO; in medical and surgical emergencies (2010-2012) with Dr. Ruy Dario Medina in the University Central Hospital Antonio Maria Pineda.

Abstract:

Background: Hypertension is an important risk factor for cardiovascular events, stroke and kidney disease, optimal hypertension control still a controversial subject in medical literature, several studies proposed the hypertension control calculating hemodynamic parameters.

Materials and Methods: In the present study we recruited 84 patients’ males (34%) and females (49%) between 32 and 95 years of age with non-controlled hypertension taken 2 or more medications and measured heart rate (HR), systolic (SBP), diastolic (DBP) andmean (MAP) blood pressure, pulse pressure (PP), cardiac index (CI) using Liljestrand & Zander modified formula to calculate stroke volume (CI = [HR*(PP/MAP)]/Body surface area), central venous pressure (CVP) using inferior vena cava diameter (IVCD), systemicvascular resistance index (SVRi = MAP/CI*80) and divided in six hemodynamic groups Hyperdynamics (Hd) were those with CI > 3,5L/min/m2, High Resistance (Hr) group when SVRi > 2500 dynas, Fluid overload (FO) when CVP > 8 cm H2O or IVCD > 2 cm and mixed types, Hd + Hr, Hd + FO and Hr + FO, a basal values was measured after 1 week washout with captopril, after washout treatment was selected according hemodynamic groups with a 6 months follow up.

Results: We found a statistical significant reduction of all parameters at the first month after treatment and hypertension control according European of Society Cardiology guidelines in 100% of patients at 3rd month of treatment with hemodynamic normalization, only Hd + FO at 6th month, with no symptomatic hypotension.

Conclusion: Hemodynamic guided treatment to control high blood pressure had good results in this study; however, bigger trials are needed to prove his efficacy.

Biography:

Professor EL-Attar HA has completed MBBch in 11/1979 from Faculty of Medicine, University of Alexandria, MS in Chemical Pathology in 4/1987 and MD in Chemical Pathology in 4/2001 from Medical Research Institute. Assistant  Professor in Chemical Pathology in 28/8/2006 and Professor in Chemical Pathology since30/8/2011 in Medical Research Institute. Alexandria University, Egypt.

Abstract:

 Background: Human Kidney Injury Molecule-1 (KIM-1) is produced in the affected segments of the proximal renal tubule whenever there is a pathophysiological state resulting in dedifferentiation of the epithelium. The kidney injury molecule-1 is a type 1 transmembrane glycoprotein (339 aa). KIM-1 ectodomain is cleaved and shed in a metalloproteinase-dependent fashion. The soluble KIM-1 protein that appears in the urine of humans is about 90 KDa. All forms of chronic kidney disease, including diabetes, are associated with tubulo-interstitial injury. Aim: The current study was performed try to assess use of urinary KIM-1/Creatinine ratio as a sensitive diagnostic tool for renal injury in the urine of patients with type 2 diabetic Egyptian patients. Methods: Eighty subjects were subjected to clinical examination included and subdivided as 20 apparently healthy control volunteers (group I) and 60 diabetic patients which were divided into 3 subgroups (Group II, Group III and Group IV) of 20 patients each: according to ACR: (ACR<30 mg/g, 30 – 299 mg/g and ≥ 300 mg/g respectively). All were subjected to laboratory investigations which included: Morning mid-stream urine sample for: 1) Complete urine analysis. 2) Quantitative measurement of urinary albumin. 3) Urinary creatinine. 4) Calculation of urinary albumin to creatinine ratio. 5) Measurement of KIM-1 (ELISA) 6) Calculation of KIM-1 to creatinine ratio. Calculation of estimated glomerular filtration rate (eGFR). Estimation of: fasting and post prandial glucose, urea and creatinine serum levels and blood level of glyclated hemoglobin (HbA1c). Results: Urinary KIM-1 levels were increased with the progression of nephropathy. Urinary KIM-1 levels were independent risk factor of (eGFR) and albuminuria in diabetic patients. Urinary KIM-1/Cr ratio was more sensitive than KIM-1. There was no correlation between urinary KIM-1/Cr ratio and GFR in all studied groups. Conclusion: Urinary KIM-1/Cr ratio is a sensitive, noninvasive diagnostic tool for kidney affection in Type 2 diabetic Egyptian patients that seem to predict renal injury in early period independent of albuminuria. Due to lack of correlation, both KIM-1/Cr and Alb/Cr ratios are required to be calculated for Type 2 diabetic patients. Recommendations: The use of KIM-1/Cr ratio as a diagnostic tool for kidney affection by measuring it in urine of Type 2 diabetic patients at risk of chronic kidney disease.

Biography:

Abstract:

Background

Improving glycemic control through lifestyle change in people with prediabetes can help prevent or delay the onset of type 2 diabetes. “Impaired fasting glucose and impaired glucose tolerance are associated with modest increases in the risk for cardiovascular disease” ¹. Study done by Diabetes Prevention Program Research Group reveals the importance of early education regarding lifestyle change s will reduce  risk of or delay the diagnosis of diabetes ².

As part of a medical directive to manage dysglycemia at  the University of Ottawa Heart Institute (UOHI), all  in- patients  are screened  utilizing HbA1C. Those identified with prediabetes  are provided with education  material on prediabetes and HbA1c and referred to a community education program closest to client’s preferred location.  These patients  are also followed  post discharge by interactive voice response.  An automated voice activated system that cues and coaches people  to eat regular meals, promotes physical activity and reminds them of the importance of attending education on prediabetes. The hospital has been referring people to several community programs over the last two years.

Purpose 

To find out whether or not people with prediabetes who are referred from a cardiac hospital, attend a community diabetes education program.

Methods

Retrospective attendance analysis of 91 people who have been referred from one cardiac hospital, UOHI, to one community program , Community Diabetes Education Program of Ottawa (CDEPO), for diabetes education. A community program with the largest number of educational sites across the city was chosen. A period of 13 months was analyzed between January 2015-January 2016.

Results

A total of 91 referrals were received for prediabetes; 30% attended a diabetes education group and 9% attended an individual session with a diabetes educator(s) (Fig.1). The results show a low attendance rate of these individuals to a community program. Further investigation is required to improve attendance rate.

Biography:

Abstract:

The human kidney releases a monoamine oxidase, Renalase, which was discovered in 2005, to the blood stream to regulate the blood pressure .Renalase decreases systemic pressure by metabolizing the circulating catecholamines.

Hypertension is highly prevalent in patients with diabetic nephropathy which is one of the leading causes (about 80%) of chronic kidney disease and end-stage –kidney disease.

When considered in isolation, hypertension and diabetes are associated with increased risk of the development of cardiovascular and renal complications. It is recognized that sympathetic nervous activation and stimulation of the rennin –angiotensin-aldosterone are involved.

The dopaminergic and rennin-angiotensin systems interact to regulate the blood pressure.

 The vasodilator, Dopamine, counteracts angiotensin receptors in the paracrine regulation of renal sodium transport.

Levels of Renalase that metabolize catecholamines are decreased in chronic kidney disease and the plasma concentration of Renalase is markadely reduced in patients with ESRD.

Chronic kidney disease is often characterized by the presence of sympathetic hyperactivity , which contribute to the development of other forms of organ damage independent of its effect on blood pressure .It is associated with heart failure , arrhythmias and atherogenesis .

Decrease Renalase level plays an important role in cardiovascular pathology

Chronic kidney disease lead to an 18-fold increase in cardiovascular complications not fully explained by traditional risk factors .

Preventing the progression of renal failure and reducing cardiovascular risk of uraemic patients are major challenges for nephrologists. Interference with sympathetic overactivity may provide a new therapeutic avenue to follow in clinical medicine.

 Aim: to assess the relationship between Dopamine and Renalase in Egyptian Type 2 diabetic patients in the presence and absence of diabetic nephropathy.

Subjects and Methods: 80subjects were divided as: Group1:10 control healthy volunteers, Group2:60 Type 2 diabetic patients and Group 3:Type 2 diabetic patients on maintenance hemodialysis .

Detailed history taken, thorough physical examination,12 lead ECG. Laboratory investigations of fasting serum glucose, urea, creatinine, uric acid, sodium, potassium, lipid profile, urinary albumin to creatinine ratio, Dpamine and Renalase .

Results:

1. Significant increase in blood pressure, both systolic and diastolic in diabetic patients and diabetic patients on maintenance hemodialysis as compared to controls.

2. No significant change in Dopamine level in between the studied groups.

3. No significant change in Renalase in Type 2 diabetic patients ,but significant increase in Renalase level in diabetic patients on maintenance hemodialysis as compared to controls (p=0.000)also to diabetic patients (p=0.004).

4. There was significant correlation between Renalase and Dopamine(r=0.261, p=0.022) , and Renalase and diastolic blood pressure (r=0.243,p=0.041) in diabetic patients.

Conclusion: Renalase is an attractive replacement therapeutic modality in hypertensive Type2 diabetic patients in order to prolong the interval between early chronic and end-stage renal failure.

Biography:

Sun Shin Yi, D.V.M., Ph.D. has his expertise in evaluation feeding behavior under hyperphagia, sleep and diabetic conditions. He has experienced at lots of preclinical studies about metabolic diseases. He has built this model after years of experience in research, evaluation, teaching and administration both in research and education institutions. He has published more than 60 papers in reputed journals and a board member of Korea Mouse Phenotying Center (KMPC).

Abstract:

In particular, sleep is known to be closely related to obesity and diabetes, so we sought to find evidence of sleep efficacy and its use in diabetes. Insomnia is not only a decrease in neurogenesis in the hippocampus, which is the backbone of short-term memory, but also in obesity and diabetes. In this study, we investigated the amount of neuroblast expression in a short DBA/2 mouse strain with a sleep abnormality, and constructed a diabetic model of C.elegans.

Following ingestion of Passion flower (Passiflora incarnate L.; PF) extract, the increase of melatonin level was confirmed in serum, and the increase of DCX was confirmed in Immunohistochemistry (IHC) in PF treated groups than in the untreated group. In addition, the anti-oxidative stress evidence at the C. elegans model was obtained of the PF treatment group, and also confirmed the high survival rate.

Taken togher, we found evidences that sleep efficacy of PF extracts not only improves neurogenesis in the subgranular zone (SGZ) of the hippocampal dentate gyrus, but also has a positive effect through resistance to obesity and diabetes that can occur with insomnia. Through the further study, we will show that PF has various positive effect on diabetes caused by DIO mice model and genetic engineered type 2 diabetic experimental animals.

Biography:

Gerald C. Hsu received an honorable PhD in mathematics and majored in engineering at MIT.  He attended different universities over 17 years and studied seven academic disciplines.  He has spent 20,000 hours in T2D research.  First, he studied six metabolic diseases and food nutrition during 2010-2013, then conducted research during 2014-2018.  His approach is “math-physics and quantitative medicine” based on mathematics, physics, engineering modeling, signal processing, computer science, big data analytics, statistics, machine learning, and AI.  His main focus is on preventive medicine using prediction tools.  He believes that the better the prediction, the more control you have.

Abstract:

Background and Aim:

The author has extended his 8-year T2D research to focus on the relationship between metabolic diseases and the probability of having a heart attack or stroke.

Material and Method:

He has developed big data numerical simulation models using ~1.5M data.  Initially, he chose age, gender, race, family history, smoking, drinking, drug abuse, medical health conditions, and weight/waistline to establish a static baseline.  He then applied hemodynamics knowledge to develop a macro-simulated mathematical model for the dynamic situations of blood blockage and artery rupture.  He utilized 72,893 data of chronic disease conditions (output data of obesity, diabetes, hypertension, and hyperlipidemia) within the past 2,274 days to compute the probability of having a heart attack or stroke in the near future.  Finally, he conducted sensitivity analyses to cover the probability variance by using different weighting factors (WF).

Results:

Comparing the results from the worst year, 2000, to the health-improving period of 2012-2018, the probability values are:

2000 with BMI 31: 74% 

2001-2006:  Three episodes of chest pain

2012 with BMI 29:  62%

2017: 26.4%

2018 with BMI 25:  31%

(Framingham 2017: 26.7%)

In summary, within eight years, he has an average of 34% probability with +/- 10% variance of WF sensitivity.

Conclusion:

The mathematical simulation results are validated by past health examination reports.  This big data dynamic simulation approach using math-physical medicine will provide an early warning to patients with chronic disease of having a heart attack or stroke in the future.

Biography:

Dr.Ravi kant is currently working as an associate professor and head, division of diabetes and metabolism in the department of medicine at All India Institute of Medical Sciences, Rishikesh. He has developed the department of medicine at AIIMS Rishikesh. He obtained fellowship in diabetes from CMC Vellore and from Harvard university .He is currently the Harvard course director for the certificate course in diabetes in India. He is also currently the secretary, South East Asian Foundation and the editor of South East Asian Medical Clinics .He is international advisor to the journal of diabetes and endocrine society of Nepal and also journal of public health and holistic medicine.

Abstract:

Background and Aim – The prevalence of diabetes in India has reached alarming levels with 8.7% of population affected as of 2015, which is expected to double in the future. The reasons for the rapid increase in prevalence of diabetes include genetic predilection of Indian population, economic boom, sedentary lifestyle, inadequate follow up and lack of disease awareness. The aim of the study was to overcome the self care deficit which would help patients to be more compliant and better in managing their illness.

Methodology – The study was conducted at weekly diabetes clinic at AIIMS, Rishikesh in which 2oo patients participated. Two sessions, each of 60 minutes were conducted fortnightly. The patients were educated by trained personnel using specially designed module in patients’ own language.  Each group consisted of 10- 15 participants. Participants were tested at the beginning and after the educational programme using a 10 item questionnaire. Data was analysed using MS Excel 2010.  Paired t test was used to find any significant difference between pre and post test score. Average learning gain was computed by Pre – post / 10- pre X100.

Results - A significant improvement in test scores after education session was noted. Average learning gain was 77.98 % ± 23.27 % after the group education. Sixty four percent participants demonstrated more than 75% learning gain.

Conclusion and further scope – A dedicated group session programme implemented in an environment conducive to learning with specially designed module has a significant impact on patients’ knowledge (64% participants demonstrated more than 75% learning gain) about the cause and treatment of their disease. The study can be extended to see if it impacts behaviour by tracing changes in glycaemic control.

Biography:

Seema Vinayak is a professor of psychology at Department of Psychology, Panjab University, Chandigarh in India. With research and teaching experience of more than two decades, she has delivered keynote addresses, research presentations, chaired sessions at national and international conferences. Widely travelled and honoured at national and international forums, Prof Vinayak has specialization in clinical psychology, organizational and media psychology.

Abstract:

Statement of Problem: Life threatening ailments can be very stressful and may require reconstructing of one's thought process and readjustment of one’s priorities in life. Though studies have highlighted the trauma faced by people diagnosed with cardiovascular diseases, there is lack of research on post-traumatic growth in patients with heart ailments. This research   focusses on cognitive and social predictors of PTG.

Methodology: About 2000 patients (undergoing treatment for heart ailment or cancer) at the hospitals located in three neighboring states viz. Punjab, Haryana and UT of Chandigarh were contacted. Out of these, who met the inclusion criteria and volunteered, 200 patients for each ailment category and 200 as control group were investigated on cognitive rigidity, meaning in life, resilience, perceived intimate partner emotional abuse, marital satisfaction and PTG.

Statistics: Mixed research with qualitative and quantative strands was used. Descriptive analyses, intercorrelation, regression analysis and 2x3 ANOVA ( with 2 levels of gender and 3 levels of conditions) were done. Besides, interviews with the participants were done.

Findings: Cognitive rigidity, perceived intimate partner abuse and marital  satisfaction emerged as significant predictors for PTG. Resilience , marital satisfaction was higher in  heart patients as compared to patients with cancer. Significant gender differences on cognitive rigidity, intimate partner emotional abuse and marital satisfaction emerged.

Conclusion and significance: Psychological intervention programs for the patients can be designed which will add to the life satisfaction and general wellbeing of the patients.

Biography:

Ginny Y. Y. Lam, RN(HK), MSN, MDEM earned her MSc in nursing and MSc in Endocrinology, Diabetes and Metabolism from the Hong Kong Polytechnic University and the Chinese University in Hong Kong, respectively. She has 13 years of nursing experience and 2 years of experience as a diabetes nurse. Currently, she is a doctoral student at the Chinese University in Hong Kong and a Nursing Educator in Hong Kong Baptist Hospital. Her research efforts are focused on the area of self-management in patients with diabetes

Abstract:

Diabetes mellitus affects about 10% of total population in Hong Kong, and type 2 diabetes (T2DM) accounts for 90% of all diagnosed diabetes cases. The standard management plan of T2DM includes diabetes self-management education and continuous diabetes support. eHealth offers a 24 h accessible platform that promotes self-management and self-care among patients with diabetes.

A fully automated mobile application called ‘iCare’ was developed, and its effect on the outcome of patients with T2DM in Hong Kong was examined by conducting a randomized controlled trial (RCT). The primary outcome was diabetes self-care behaviour and the secondary outcome was glycated haemoglobin (HbA1C).

The study was conducted at a diabetes clinic in a regional hospital in Hong Kong from June, 2015 to October, 2016. Those eligible patients were approached for the study and screened for their interest and final eligibility. After explanation and obtaining the written consent, they were randomised into a control group or intervention group. The participants in the control group received usual care and intervention group received eHealth intervention - iCare on top of the usual care. All outcome measures were assessed at baseline (T₀) and 3 months post intervention (T₁) in both groups. Intention-to-treat (ITT) and per- protocol analyses were performed to address the effect of attrition.

A total of 170 eligible participants were randomised into the control group (n= 85) or the intervention group (n= 85). No significant differences were observed in the group-by-time interaction for all constructs of diabetes self-care behaviour in the adjusted model (diet p=0.804; exercise p=0.912; medication p=0.892; self-monitoring blood glucose [SMBG] p=0.109; and foot care p=0.187). Similar to the primary outcome, the secondary outcome did not differ between the two groups after the 3-month intervention. Results of per-protocol analysis were comparable with the findings of the ITT analysis.

Results showed that the eHealth intervention iCare did not significantly improve any outcome measurements when compared with usual care after the 3-month study period. Modest improvements were observed in all constructs of diabetes self-care behaviour in the intervention group. Future research and development of eHealth applications may be needed to strengthen the interactivity of the eHealth design and to identify the aspects and extents that can facilitate self-management among patients with T2DM.

Biography:

Chacón-Lozsán F was born Venezuela, polyglot, graduated as Medical Doctor in UCLA (Venezuela) 2014, Graduated in Critical Care Medicine -"Universidad Central de Venezuela"​, University Central Hospital-Caracas, and Master degree Student in Higher Education at the International Iberoamerican University. Scientific activity since 2007 with Rafael Bonfante-Cabarcas MD PhD on Neurochemical and Molecular Pharmacology Laboratory in behavior,cardiac molecular electrophysiopathology and Chaga’s Disease with training in statistics, critical reading and redaction of scientific production, molecular electrophysiology, biochemistry and bioterious management. Student fellow in Cardiology (2010-2012) with Bartolomé Finizola MD PhD FACC in the Cardiovascular Association ASCARDIO; in medical and surgical emergencies (2010-2012) with Dr. Ruy Dario Medina in the University Central Hospital Antonio Maria Pineda.

Abstract:

Biography:

Abstract:

Objective:

To assess skin distribution and expression of AGEs, RAGE and GLO-I in patients with 40 years of diabetes mellitus and to correlate these expressions with measures of small and large nerve fibre damage.

Methodology:

Sixty-seven patients with type 1 diabetes mellitus of short (<15 years, n=20), intermediate  (15-40 years, n=25) and long (>40 years, n=22) duration and 34 nondiabetic controls underwent diabetic neuropathy assessment: Neuropathy disability score (NDS), quantitative sensory testing (QST) including vibration pressure and thermal thresholds, nerve conduction studies (NCS), deep breathing heart rate variability (DB-HRV), corneal confocal microscopy (CCM) and intraepidermal nerve fibre density (IENFD) and AGEs, RAGE and GLO1-I expression in foot skin biopsies.

Results:

Patients with 40 years of diabetes demonstrated higher skin AGEs and RAGE and lower GLO-I expression. Patients with 40 years of diabetes who escaped diabetic neuropathy exhibited lower skin AGEs and RAGE and higher GLO-I expression in the epidermis, microvessels and basement membrane as compared to those with neuropathy and these expressions correlated with IENFD, CCM and NCS measures.

Conclusions:

Patients with 40 years of diabetes and no diabetic neuropathy have decreased skin  AGEs and RAGE and increased GLO-I expression suggesting a potential role for these macromolecules as aetiological, marker of the disease as well as therapeutic target for diabetic neuropathy.

Biography:

Vivek Kamath founder of heal the world organization is a Reiki Master, Mexican Healer, Melchizedek Healer, Crystal Healer and Past Life Regression Therapy Expert. He has healed many diabetic patients (Type1, Type2, Type 3/1.5/LADA) without any medicines. He has also healed blood pressure (both high and low blood pressure), heart disease (removed the heart blockages), removed kidney stones, ovarian cysts, fibrosis of the breast, fatty liver, lungs disease, cured sinusitis, sever joint pain, lumbar L5 spinal disk pain, Sciatica pain, neck pain, constipation, rheumatoid arthritis, glaucoma,migraines,headaches,insomnia,stomach related problem, IBS, diabetic gum problems, skin problems( dry skin, eczema) and chronic nasal allergies, nasal blockages without any medicines. Some of the above treatments have been completed within a week to maximum 1 month duration.  

Abstract:

Statement of the Problem:  Heart Diseases such as High Blood Pressure, Low Blood Pressure, High Cholesterol, High Triglycerides and Heart Blockages.

Heal The World – A revolutionarily health care organization has been formed in Bangalore, India to heal any diseases without any medicines. We use powerful ancient healing techniques such as 1. REIKI 2. MEXICAN Healing 3. Crystal Healing 4. Melchizedek Healing 5. Past Life Regression therapy to heal any diseases.

We have healed many blood pressure, cholesterol and high triglycerides patients within a month’s time without any medicines.

In fact, with the help of Reiki Distant healing, we have healed low blood pressure diseases within 15 days.

Recently, we have tested few patients of high blood pressure (180/130) and we provided them 1 Mexican healing and immediately after the 1 Mexican healing, we checked their blood pressure it came down by 20 units. (160/100). Furthermore, we gave few Reiki Distant healings to high cholesterol (400) and high triglycerides (900) and within few days their cholesterol came down to (240) and triglycerides came down to 650.

We have also removed CAD (triple vessel disease) 3 blockages within 18 days of Reiki Distant and 5 Mexican healing sessions. Till now, we have removed the blockages of 2 patients.

The first thing what we do in healing is to remove the chest pain within few days. Once we remove the pain, then we start working on reducing their blood pressure, bringing cholesterol to normal level and cleansing all the nerves, valves and organs etc. The energy which we pass in the heart and valves helps to remove the blocks and negative energy from the organ.  

More importantly, in some case Reiki Distant healing has been proved very effective to remove the pain.