Global Meeting on Diabetes and Endocrinology July 23-24, 2018 Kuala Lumpur, Malaysia

Biography:

Punit Gupta is the Honorary Nephrologist to the Governor of Chhattisgarh State since 2009. He is the Chairman and Member of many important academic and management committees of various government medical institutions in the country and the Pt. Deen Dayal Upadhyay Health Sciences University, Raipur. He has presented more than 160 research papers and abstracts on kidney diseases in tribal populations at renowned national and international conferences. He was awarded internationally prestigious APCN Developmental awards in Malaysia 2008 and a Follow Scholarship by International Society of Peritoneal Dialysis in Turkey 2008. He has developed portable dialysis machine (MAKE-D) for 60 billion kidney patients in world who require dialysis many times in a week. He has developed an abdominal pressure measurement scale, which is very useful of continuous ambulatory peritoneal dialysis patients (type of dialysis). He has developed and economic, efficient and effective walkie talkie system for consultation and directions to the hospital staff and doctors.

Abstract:

Introduction: The incidence of diabetes kidney disease continues to rise and has quickly become one of the most prevalent and costly chronic diseases worldwide. A close link exists between diabetes kidney disease and Cardiovascular Disease (CVD), which is the most prevalent cause of morbidity and mortality in diabetic patients.

Material & Methods: The present study was conducted in the Nephrology Unit Department of Medicine, Dr B.R.A.M. Hospital Raipur (C.G.) on 42 patients which included 20 patients of Diabetic Nephropathy as cases and 22 non diabetic patients as controls. The results was only a slight predominance of males over females in cases group (11:9). Mean age for 20 cases was 55.05 years. Maximum no. of patients (45%) were in stage IV diabetic nephropathy while there were no patients in stage I or II diabetic nephropathy.

Result: 70% of cases had hemoglobin >11 gm%. Mean hemoglobin was 11.75±2.88 gm%. Mean TLC count was 8615 cells/cumm. 80% of patients of diabetic nephropathy had normal TLC counts. Mean eGFR was 68.97±25.75 ml/min/1.73 sq. m in patients of diabetic nephropathy. Maximum number of cases (45%) had eGFR between 60-89 ml/min/1.73 sq. m. Mean serum creatinine was 1.23±0.62 in cases and 1.12±0.26 in controls with the difference between two groups being non-significant (p>0.05). About one third of patients of diabetic nephropathy had hypoalbuminemia. Hypercholesterolemia was present in about only 15% of cases. Mean serum cholesterol was 163±48.77 mg%. Hypertriglyceridemia was present in about only 15% of cases. Mean triglycerides was 138.75±78 mg%. All the patients of diabetic nephropathy in our study had some echocardiographic abnormality. Left Ventricular Diastolic Dysfunction (LVDD) was the most common abnormality present in 55% of patients while LV systolic dysfunction was present in 45% of cases. Mean EF was 47.67%. Coronary and renal angiography was done in 15 cases and 22 controls. Out of these 60% cases and 72% controls had significant coronary artery disease. Difference between two groups was non-significant (p>0.5, odds ratio=0.56). 87.5% of males in cases group had coronary artery disease in comparison to 57.14% female patients. Renal artery stenosis was found in 26.67% cases and 22.72% controls. This difference was statistically insignificant (odds ratio=1.23). In cases group, 80% of hypertensive patients had significant coronary artery disease as compared to 50% in normotensive patients. 40% of hypertensive patients had renal artery stenosis as compared to 20% in normotensive patients in cases group. Only 22.22% of patients having significant coronary artery disease had high serum cholesterol. 25% of patients having renal artery stenosis had high serum triglycerides. 33% of patients from cases group having significant coronary artery disease had hypoalbuminemia. Out of 9 patients in cases group having significant coronary artery disease none had hypothyroidism while 1 (11.11%) had hyperthyroidism.

Conclusion: Coronary artery disease is the most common abnormality seen. Male were most suffered from artery disease as compared to females. Renal artery stenosis was most common in disease. Coronary artery disease was common in patients with hypertension. Renal artery stenosis was most commonly associated with higher serum triglycerides. Hypothyroidism was more common in patients with significant coronary artery disease. Patients with diabetic nephropathy with geriatric age group had significant coronary artery disease.

Biography:

Dr. L.B.L.Prabodha works as a Senior Lecturer in Department of Anatomy, Faculty of Medicine, University of Ruhuna.

Abstract:

Background & Aim: Diabetic Peripheral Neuropathy (DPN) is one of the devastating complications of Type-2 Diabetes Mellitus (T2D) that presents in around 50% of cases. There is increasing evidence that genetic variants also contribute to the development of DPN. Ethnic differences in the distribution of these variants have also been reported. The objective of this study is to describe the Minor Allele Frequencies (MAF) of Single Nucleotide Variants (SNV) associated with the susceptibility and prognosis of DPN in Sinhalese in Sri Lanka and to compare the corresponding MAF in 5 different populations reported in the 1000 Genomes database.

Materials & Methods: The genetic variants associated with the susceptibility and prognosis of DPN were identified by an extensive search of scientific literature published in PubMed using the search terms ‘Diabetic peripheral neuropathy/genetics’, and ‘genome-wide association study’. The identified variants were annotated using the SnpEff software to filter the exonic and splice-site variants. The MAF of each of the selected variants in the Sri Lankan population were calculated using the de-identified exome sequencing data of 47 Sinhalese individuals available in the genomic database maintained at the Human Genetics Unit, Faculty of Medicine, University of Colombo, Sri Lanka. The MAF of these variants were compared with the corresponding frequencies in 5 different populations reported in the 1000 Genomes phase 3 release database namely: Americans of African Ancestry in SW USA (ASW), Bengali from Bangladesh (BEB), Utah residents with North and Western European Ancestry (CEU), Han Chinese in Beijing, China (CHB) and British in England and Scotland (GBR).

Results: The MAF of exonic and splice-site variants of BDKRB2, ADIPOQ, VEGFA and HSPA5 genes in the Sri Lankan population showed statistically significant (p<0.05) differences in comparison to all the other globally represented populations. The MAF of MTHFR variant in CEU, CHB and GBR, CYBA variant in CHB and PPARG in ASW populations, respectively showed statistically significant differences (p<0.05). The MAF of KCNJ11 and APOE gene variants in the Sri Lankan population showed no statistically significant differences compared with all the other globally represented populations.

Conclusion: This study shows that the MAF of important exonic and splice-site variants of key genes associated with DPN in Sinhalese in Sri Lanka had statistically significant differences when compared with other global populations. It would be necessary to undertake studies to understand the prognostic and therapeutic implications of these variants in a large cohort study.

Biography:

Soon Hui Teoh is currently pursuing Master’s degree in Food and Nutritional Science in the Graduate School of Tokyo University of Agriculture. She has her expertise in the histopathological analysis of type-2 diabetes mellitus in animal models, especially renal complications.

Abstract:

Type-2 diabetes mellitus had become an international health concern with its growing number of patients globally. At the same time, excessive salt consumption was also seen as a major cause of diseases such as hypertension and may expedite renal complications in diabetic patients. In this study, we investigated the effects of excessive sodium chloride supplementation on the kidney of the Spontaneously Diabetic Torii (SDT) fatty rat, an obese type-2 diabetes model. Male and female SDT fatty rats and normal Sprague Dawley (SD) rats at 5 weeks of age were loaded with 0.3% NaCl in drinking water for 13 weeks. Blood serum and urinary parameters were observed throughout the experiment and kidney samples were examined in histopathological and genetical analyses. Significant changes on the body weight, blood pressure, urine volume, creatinine clearance, BUN, relative gene expressions of TNF-α, IL-1β, MCP-1 and TGF-β were observed in the salt loaded male SDT fatty rats. Urinary L-FABP (Liver type Fatty Acid Binding Protein) and albumin levels were higher observed in the salt loaded male SDT fatty rats throughout the period, but urinary albumin levels in the female SDT fatty rats remain unchanged. In the kidney, slight Armanni Ebstein lesions, tubular regeneration, hyaline cast and inflammatory cell infiltration were observed in female SDT fatty rats while the levels of some findings were higher in the salt loaded group. The kidney of the salt loaded male SDT fatty rats demonstrated higher degree of findings compared to the female group and the male unloaded group. Increased levels of urinary biomarkers and histopathological changes in salt loaded SDT fatty rats’ shows that excessive salt consumption may act as a diabetic pathology exacerbation factor, but the pathosis may be influenced by gender difference. Urinary L-FABP levels may act as a useful biomarker to detect slight tubular damages in the kidney