Biography:

Jun Sun is an Associate Professor at the University of Illinois at Chicago. She is a fellow of American Gastroenterological Associate. Her key achievements include characterization of vitamin D receptor regulation of microbiome in intestinal homeostasis and inflammation, identification of dysbiosis and intestinal dysfunction in ALS, and identification of bacteria in regulating intestinal stem cells. She has published over 120 scientific articles in peer-reviewed journals, including Cell Stem Cells, Nature Genetics, Gut and JBC. She is in the editorial board of 10 scientific journals. Her research is supported by the NIH, DOD and other awards.

Abstract:

Obesity occurs when there is an unfortunate combination of environment triggers, genetic susceptibility, and dysbiosis. A positive association between obesity and vitamin D deficiency have been found in human obesity for years, but determining cause and effect has been difficult. Majority of the biological function of vitamin D is regulated by vitamin D receptor (VDR). Our Nature Genetics paper has demonstrated that human VDR gene is a key host factor to shape gut microbiome. Further, we have demonstrated that intestinal epithelial VDR conditional knockout (VDRΔIEC) leads to dysbiosis (imbalanced microbiome). However, the study on biological function of VDR in obesity-associated dysbiosis and inflammation is still limited. In the current study, we showed that conditional removal of VDR in the intestinal epithelium made mice more susceptible to obesity. There are decreased genus Lactobacillus and butyrate-producing bacteria in the VDRΔIEC mice. Interestingly, the genus Lactobacillus was enriched on calorie-restricted low-fat diet. The butyrate-producing bacteria play an important role in blood glucose regulation and lipid metabolism. The dysbiosis observed in VDRΔIEC mice is very similar as the bacterial profile in obesity. Dysbiosis controls metabolic endotoxemia during obesity and bacterial factors, such as lipopolysaccharide (LPS). Our
data showed accumulated LPS in the blood of VDRΔIEC mice. Increased inflammation and insulin intolerance were found in the VDRΔIEC mice on high fat diet. Taken together, our study has demonstrated that VDR regulation of microbiome contributes to the development of obesity.

Biography:

Sergio Wehinger has completed his PhD in Biomedical Sciences from University of Chile in 2013 and actually is the Director of Magister in Biomedical Sciences of University of Talca. He has published in more than 10 papers and currently he is investigating the molecular mechanisms involved in the cellular failure of the beta pancreatic islets, which is induced by elevated free fatty acids and oxidative stress levels, to elucidate how to abolish these processes.

Abstract:

Introduction: Elevated levels of fatty acids (FFA) induce cellular dysfunction, leading to a phenomenon known as “lipotoxicity”, which involves insulin resistance and beta pancreatic cell damage, events that has been observed in Metabolic Syndrome, favoring the development of type 2 diabetes mellitus (T2DM). Although several studies have addressed lipotoxicity in beta cells, many aspects of cellular pathways involved remain to be defined. We previously reported that the expression of the protein caveolin-1 (CAV1) promotes lipotixicity-induced apoptosis in vitro in a mouse beta cell line (Wehinger et al, 2015). However, if this phenomenon is pathophysiologically relevant in a whole organism, remains to be elucidated.

Strategy to address the problem: We evaluated the metabolic profile of C57BL/6J wild type (WT) and CAV1-null mice exposed to a High Fat Diet (HFD: 60% fat) for three months as well as the viability of pancreatic islets from these animals. We founded that CAV-1 null mice showed higher levels of triglycerides and cholesterol compared to WT mice, although null mice presented a better response to the glucose tolerance test. Finally, islets from CAV-1 null mice showed lower levels of apoptosis after HFD.
 

Conclusion: Although null mice showed a metabolic profile apparently more lipotoxic, they were more resistant to the deleterious effects on beta islets, accordingly with our previous results in vitro. Understanding the signaling pathways associated with FFA-induced beta cell demise could help to identify targets for advanced therapies in preventing T2DM derived from
Metabolic Syndrome.

Biography:

ASM Giasuddin completed his MSc in Biochemistry from University of Dhaka, Bangladesh in 1969, He obtained PhD at the age of 27 years from University of London, UK in April 1976 and continued postdoctoral fellowships at London University until May 1982. He has been a Professor of Biochemistry and Immunology for the last 20 years since 1996 in various medical schools and universities in different countries. Presently, he is serving as Director of Medical Research Unit (MRU), The Medical and Health Welfare Trust (MHWT), Dhaka, Bangladesh. He has published more than 125 articles in reputed international and national journals

Abstract:

Objectives: As no studies were reported from Bangladesh, the present investigations were conducted on serum lipid profile, i.e. triglyceride TG), total cholesterol (TC), low density lipoprotein-cholesterol (LDL-C), high density lipoproteincholesterol (HDL-C) and lipoprotein (a) [Lp(a)] status in Bangladeshi patients with cholelithiasis and effects of laparoscopic cholecystectomy on them.

Patients & Methods: Adult patients (n=44) with cholelithiasis and normal controls (NC) (n=30) were included in the study. The blood samples were taken from fasting patients at diagnosis before cholecystectomy (Serum-I0), gall bladder bile during cholecystectomy (Bile- I0) and blood samples again after 2-3 months at follow-up (Serum-II0) and from fasting NC subjects.TG, TC, LDL-C and HDL-C were quantitated by standard methods and Lp(a) status by immunoturbidimetric method in serum and bile using research kits from reputed companies. The results were compared statistically by ANOVA, Student’s t-test and Chi-squared test using SPSS program.
Results: TG level was elevated in Serum- I0, Bile- I0 and Serum- II0 of patients, being highest in Bile- I0 compared to controls (NC) (p<0.001). TG level was reduced in serum -II0 after cholecystectomy compared to Serum- I0 and Bile- I0, although it remained significantly elevated compared to controls (NC) (p<0.001). TC level was elevated in Bile- I0 compared to Serum- I0 and Serum- II0 (p<0.001). Interestingly, TC was elevated in Serum- II0 after cholecystectomy, although no significant difference was observed between NC and patients Serum- I0 (p=0.835). LDL-C levels in NC, Serum- I0 and Serum- II0 were similar (p=0.126, p=0.121), although Serum-II0 levels was elevated compared to Serum- I0 (p<0.001) and it was much elevated in Bile- I0 (p<0.001). HDL-C levels were similar (p>0.05) among NC, Serum- I0 and Serum- II0, but it was higher in Bile- I0 significantly (p<0.001). Lp(a) (mg/dl) was much higher in patients compared to NC (Mean± SD: 29.07±14.17/NC, 290.84± 110.93/Serum-I0, 37.12±28.61/Bile-I0, 203.70± 90.13/ Serum-II0), (P< 0.001). Lp(a) was lowered after cholecystectomy, but remained elevated in patients Serum-II0 compared to NC significantly (P <0.001). No significant difference was observed for Lp(a) levels between NC and patients Bile-I0 (P = 0.173). The proportions of patients for Serum-I0, Bile-I0 and Serum-II0 with Lp(a) levels above and within normal limits and their statistical analyses showed significant associations (P<0.001)

Conclusion: Alterations in lipid profile and Lp(a) in cholelithiasis were significant but complex and laparoscopic cholecystectomy had profound effects on them indicating a special function of gall bladder relevant to their metabolism. The results were discussed accordingly.

Biography:

Charlotte Summers, BSc Psychology, charlotte@diabetes.co.uk

COO, Diabetes Digital Media

Charlotte is responsible for the creation and delivery of digital education programs with proven health outcomes and cost savings. With a background in psychology, Charlotte's passion and expertise lie in creating offline accountability and sustainable health behavioural change in a digital age.

Arjun Panesar, MEng Artificial Intelligence, arj@diabetes.co.uk.

Co-founder, Diabetes Digital Media

Arjun has a decade of experience with intelligent health systems and big data. Holding a Masters in Artificial Intelligence from Imperial College London, Arjun's focus is transforming healthcare through empowering patients - through the use of real-world big data and genomics.

Abstract:

Program Topic Areas:

1. Diabetes, obesity, metabolic health

2. Digital Health

3. Nutritional guidelines and best practice

Overview:

For the past few decades, diet and lifestyle programs for adults with type 2 diabetes have included recommendations to follow a low-fat diet, often using in-person programs. In

parallel, however, research has shown that carbohydrate-reduced diets may more effectively reduce body weight, improve glycemic control, and reduce hypoglycemic medications. Plus, online interventions have shown promise for encouraging these dietary changes. The Low Carb Program has combined these approaches, teaching a carbohydrate reduced, real-food way of eating to adults with type 2 diabetes supported by digital approaches enabling behaviour change and sustainable health improvements.

The goals of this talk are to:

(1) examine the preliminary efficacy of these carbohydrate-reduced digital interventions for reducing body weight, improving glycemic control, and reducing hypoglycemic medications in adults with type 2 diabetes.

(2) Highlight the efficacy of a digital intervention as a method of delivery and behavior change support. The presenters will talk about a commercially available digitally supported program that teaches a low-carbohydrate diet using online videos- and handout-based lessons, weight self-monitoring, dietary self-monitoring, digital social support groups, and medication management through the participants' own healthcare team. Results will be presented from a prospective longitudinal study. Overall, it is the presenters hope that the audience will be provided with new ways to think about diet and lifestyle interventions for adults with type 2 diabetes.

Learning Objectives:

- Learn how the Low Carb Program, a digital health intervention has been enabling adults with type 2 diabetes to implement a carbohydrate-reduced diet and lifestyle, in particular, understand how the components of this automated online low-carbohydrate program influence behaviour change

- Understand the potential impact of carbohydrate-reduced diets on weight loss, glycemic control, and medication reduction in adults with type 2 diabetes.

ABSTRACT

Background

Type 2 diabetes has serious health consequences including blindness, amputation, stroke, and dementia, and its annual global costs are more than $800 billion. Although typically considered a progressive, nonreversible disease, some researchers and clinicians now argue that type 2 diabetes may be effectively treated with a carbohydrate-reduced diet.

Objectives

Our objective was to evaluate the 1-year outcomes of a digitally delivered Low Carb Program (LCP), a nutritionally focused, 10-session educational intervention for glycemic control and weight loss for adults with type 2 diabetes. The program reinforces carbohydrate restriction using behavioral techniques including goal setting, peer support, and behavioral self-monitoring.

Methods

The study used a quasi-experimental research design comprised of an open-label, singlearm pre- and post-intervention using a sample of convenience. From adults with type 2 diabetes who had joined the program and had a complete baseline dataset, we randomly selected participants to be followed for 1 year (N=1000; mean age 56.1, SD 15.7, years; 59% (593/1000) women; mean HbA1c 7.8, SD 2.1, %; mean body weight 89.6, SD 23.1, kg; taking an average of 1.2 diabetes medications).

Results

Of the 1,000 study participants, 708 (70.8%) individuals reported outcomes at 12 months, 672 (67.2%) completed at least 40% of the lessons, and 528 (52.8%) completed all lessons of the program. Of the 743 participants with a starting HbA1c at or above the type 2 diabetes threshold of 6.5%, 195 (26.2%) reduced their HbA1c to below the threshold while taking no glucose-lowering medications or just metformin. Of the participants who were taking at least one hypoglycemic medication at baseline, 40.4% (289/714) reduced one or more of these medications. Almost half (46.4%, 464/1000) of all participants lost at least 5% of their body weight. Overall, glycemic control and weight loss improved, especially for participants who completed all 10 modules of the program. For example, participants with elevated baseline HbA1c (≥7.5%) who engaged with all 10 weekly modules reduced their HbA1c from 9.2% to 7.1% (P<.001) and lost an average of 6.9% of their body weight (P<.001).

Conclusions

Especially for participants who fully engage, an online program that teaches a carbohydratereduced diet to adults with type 2 diabetes can be effective for glycemic control, weight loss, and reducing hypoglycemic medications.