2^nd Global Meeting on Diabetes and Endocrinology May 30-31, 2019 Istanbul, Turkey

Diabetic nephropathy is the disease/ damaged caused by diabetes to your kidney, which in severe cases can lead to kidney failure. The waste from our blood is filtered by the tiny blood vessels present in our kidney, they can be destroyed by high blood sugar level in our body. The body retains excess water and salts than required leading to weight gain and ankle swelling. This leads to malfunction or kidney failure in later stages. No symptoms are shown in earlier stages so, regular urine tests are required to detect any kidney damage.

Diabetes may also lead to damage to nerves, which can lead to difficulty in emptying your bladder and creating pressure injuring your kidney. Long time retention of urine in bladder leads to infections as bacterial growth in urine with high blood sugar level is high.

About 30% of patients with Type 1 diabetes and 10 to 40 % of those with Type 2 diabetes gradually will suffer from kidney failure.

Diabetic retinopathy is caused due to damage to the blood vessels in the tissue of retina. Poor control of blood sugar is one of the risk factors. The blood vessels may swell and leak fluid and abnormal development of new blood vessels on the surface of the retina is seen. The accompanying scar tissue might contract and detach from retina.

Symptoms in initial stages include floaters, blurriness, dark areas of vision and difficulty perceiving colors. There is no cure for diabetic retinopathy but can be treated laser treatments for and surgical removal of vitreous gel (vitrectomy) for better vision.

Individuals with diabetes have more critical issues with teeth and gum, so great care is necessary. Periodontal disease is a common dental problem seen in individuals with diabetes. Risk of gum problems is more in aging people and with poor blood sugar maintenance. With infections and gum issues the blood sugar levels increase and makes it harder to control diabetes due to less susceptible to bacteria infecting the gums.

Diabetes can affect any part of the body including skin. It sometimes helps in recognizing persons with diabetes earlier. Most of the skin conditions can be easily treated. The skin problems are simple but easily prone by diabetic person. Other skin problem like diabetic dermopathy, necrobiosis lipoidica diabeticorum, diabetic blisters, and eruptive xanthomatosis are mostly likely affected in diabetic persons only.

There can be many types of diseases associated with skin which can be caused by Diabetes:

Adults with diabetes are more prone to cardiovascular complication (6% of the individuals) like atherosclerosis which narrow the arteries and leads to reduced blood flow to the heart and other body parts. The partial blockage of the coronary arteries produces angina (chest pain) and the complete blockage lead to heart attack. Atherosclerosis also leads to stoke the complete blockage of blood flow to brain and peripheral arterial disease – poor supply of blood to the legs. These are the main reasons for the death of most people with diabetes.

Maintaining a proper diet is very essential in diabetic patients in order to reduce the risk of diabetic complications. A healthy eating pattern and proper physical activity is the key component. Generally low carbohydrate is insisted as these are macronutrients which raises the blood glucose levels, high fiber diet is preferred, foods like whole grains, vegetables, fruits, and nuts, low fat food are best source. Some of the methods for healthy diet plan are Glycemic index, carbohydrate counting, the MyPlate method, and the TLC diet plan

Weight management is a key to a healthy lifestyle.

Obesity is one of the risk factors in development of insulin resistance which are compensated by pancreatic beta cells for insulin resistance by augmenting insulin secretion and the failure of beta cells is believed to cause pre-diabetes which leads to diabetes. Changes of developing type-2 diabetes is high in overweight people.

Fat tissues produces hormones which effect the cell growth and leads to cancer. Obesity in children is seen mainly due to early onset of puberty, menstrual irregularities during adolescence and polycystic ovary syndrome, It can be prevented by choosing healthy diet and regular physical activity.

Women with high BMI’s have high risk of ovulatory problems and response poorly to fertility treatment.

Neuroendocrinology is the study of interaction between nervous system and endocrine system which regulate physiological process in our body. Hypothalamus maintains homeostasis, regulating reproduction, metabolism, osmolarity and blood pressure in our body with the help of neuroendocrine system. Neuroendocrine cancer is a malignant tumor starting in neuroendocrine cells. These tumors are commonly occurred in intestine called carcinoma tumors. Pancreatic neuroendocrine cancer forms in islet cells. Symptoms may or may not be shown.

Diabetic patients should monitor their feet regularly to avoid risks which may lead amputation. Even minor wounds like blister to foot lead to serious consequences, as blood flow decreases in diabetic person the wound healing is delayed leading to infection and spread of infection quickly. Predominant pathogens include gram +ve cocci especially staphylococci and streptococci. Chronic or previously treated wounds lead to several microbial cultures for which appropriate antimicrobial therapy is required.

Pediatric diabetes is a condition is children dealing with endocrine disorders like physical growth and sexual development and diabetes. In pediatric type 1 diabetes the body loses its ability to produce insulin due to autoimmune destruction of beta cells and most of the pediatric patients with diabetes have type 1 diabetes depending lifelong on exogenous insulin. Children are diagnosed with type 1 diabetes are mostly obese and with type 2 are at high risk of cardiovascular diseases and microvascular complications.

Reproductive endocrinology is a surgical subspecialty of obstetrics and gynecology which trains physician in reproductive filed about hormonal functioning. Pregnancy is a significant stage of a women’s life. It is called as incubation where posterity is created in women so, care should be taken that both the posterity and the women are safe. A pregnant woman and the child are at high risk of thyroid disorder following infertility, miscarriage and complications during pregnancy and labor. Thyroid aliments in women can cause and issue with menstrual period, problem getting pregnant and problem amid pregnancy.

Biomarker is a naturally occurring molecule, gene or a character which helps in identifying the diseases. In case of diabetes HbA1c is considered as a biomarker to identify risk factors for retinopathy, nephropathy and vascular diseases. These provide preventive measures at the subclinical stage. The well organized and usage of biomarker within the growth of anti-diabetes medication can help in better and quick understanding of the pathological process of diabetes.

The small butterfly shaped gland located at the base of the neck at adams apple is called as thyroid. It is a part of the endocrine system, which is responsible to co-ordinate many body’s activities. Thyroid glands produce prohormones which regulate the body’s metabolism. When thyroid produces excess of hormones leading hyperthyroidism and when less hormones are produced leads to hypothyroidism. Thyroid diseases are most likely to affect women than men. In women infertility, miscarriage, menstrual period, problems during pregnancy and childbirth.  

Inborn hypothyroidism is a confusion that influences in newborns during childbirth, it occurs due to loos of thyroid capability due to decreased or no growth of the organ.

Graves’ disease is an immune system disorder which leads to excess production of thyroid hormones called as hyperthyroidism. The thyroid hormones metabolism is regulated by protein, fat and carbohydrates.

The main aim of diabetes complication and management is to bring the carbohydrate metabolism to normal state. In order to achieve it patients with insulin deficiency are with insulin injections or pumps and patients with insulin resistance are treated with proper diet maintenance and exercise. The other complication caused due to other disease are to be treated or prevented. Maintaining a healthy diet is best to have a healthy living with or without diabetes.

Diabetes is a main factor for cardiovascular disease, development of other secondary conditions. Regular check-ups on blood pressure, cholesterol, LDL, HDL and triglyceride levels, eye examination to prevent diabetic retinopathy, foot care specialist is better to prevent diabetes occurrence.