2^nd World Congress on Nutrition and Obesity Prevention March 21-22, 2019 Dubai, UAE

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The T2DM in adulthood is strongly related to weight gain and excessive accumulation of pancreatic and hepatic fat. It is very uncommon to have remission without bariatric surgery. Acute negative energy balance can reverse the twin defects of beta cell failure and insulin resistance alone with diet restriction to around 700 kcal that results in decreased pancreatic and liver triacylglycerol stores. Weight loss of at least 10-15 kg has been shown to achieve euglycemia in people with shortduration T2DM for at least 12 months. A 48-year old diabetic male presented to Faiha Specialized Diabetes, Endocrine and Metabolism Center two years ago with very poorly controlled T2DM that was diagnosed more than 3 years ago, along with severe hypertension and marked dyslipidemia. He underwent complete remission of his diabetes aft er losing 18 kg of his original weight (58 kg), with a very good euglycemia measures, on no treatment at all for the last two years. Th e eff ect that extends to make him have normal blood pressure and normal lipid profi le, with decreased cardiovascular risk from 26% to be less than 1%.

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Archana Arora is a Registered Dietitian and has been practicing for more than 20 years in the fitness, healthcare, wellness and catering industries. She has completed her Masters in Food and Nutrition in 1995 followed by an internship at the All India Institute of Medical Sciences, New Delhi. Currently, she is working as a Senior Dietitian and Health Coach at NU Foods, Dubai.

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Way of life is central to human wellbeing, from what we eat, how much we move, what we think, what chemicals we are exposed to, how we deal with our emotions and the quality of sleep and the list goes on. Epigenetics (a change in our genetic activity without changing our genetic code) shows that genetics is only 30% of the health equation, with lifestyle choices being 70%. But do we realize it is the wrong lifestyle choices we make, that prepare our body for disease and lead to death. Self-analyzation, willingness to change, continuous wellness journey with trustworthy professional, self-effi cacy evolution (people’s belief that they have the ability to perform particular behaviors) and perseverance can be the most obvious drivers of signifi cant health evolution in your life. With practice, we can enhance our wellbeing and achieve a state of balance and contentment. Lifestyle choices that we make are the basis of our well-being and enhanced quality of life.

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Ragdah A Hamid has completed her Bachelor’s degree in Nursing from The University of Jordan and her Post Graduation Diploma in Diabetes Primary Care from St. Geroge University School of Medicine. She is the Diabetes Nurse Educator in King Saud Medical City, Riyadh.

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Introduction: The Diabetes Nurse Educator (CDE) role in King Saud Medical City is a new approach to improving the quality of staff competencies in the care of patients with diabetes. The Diabetes Nurse Educator is an advanced nursing clinician with a focused expert practice area who works to improve the care at the bedside by combining roles as clinician, consultant, researcher, educator, and manager. The Diabetes Nurse Educator has specific responsibilities in serving as an expert in the specialty, ensuring the incorporation of evidence-based practices, promoting research, evaluating the staff nurses’ practice, providing continuous learning opportunities, and promoting critical thinking and problem-solving.

Location/Setting: King Saud Medical City-Riyadh, Endocrinology Department – Diabetes Division Outpatient Clinic and In-patient Units- General Hospital Objective: The goal of implementing the Diabetes Nurse Educator role at King Saud Medical City (KSMC) was to improve the quality, safety, effectiveness, and efficiency of staff nurses caring for patients with diabetes.

Activities: The Diabetes Nurse Educator activities include: The Development and Implementation of Educational Programs for Staff Nurses, Participating in Staff General Nursing Orientation Program (GNO),Organizing Hospital Continuous Nurse Education (HCNE) and Unit Continuous Nurse Education (UCNE) activities in clinical areas Developing Multidisciplinary Educational Programs through the year with other Health Care Professionals, Leading Nursing Grand Rounds and In-service Education, Provide Clinical Resource and Consultation to Staff Nurses in Collaboration with the Endocrine Team, Developing and Implementing Written Protocols and Order Sets in Coordination with Endocrine Team, Working within the community to promote health care including education and training for Community to Support Workers

Conclusion: The CDE plays an integral role in the prevention, diagnosis and adequate management of diabetes. This specialist role can increase skills, knowledge, and confidence, as well as support and empower staff nurses who deal with diabetic patients and help to reduce the chances of developing further complications of the disease.

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Maha Mohammed Arnous has completed his MD degree from School of Medicine in King Fahad Medical City in Riyadh, Saudi Arabia. She is the Senior Resident of Community and Family Medicine at Security Forced Hospital. She is very active in clinical research of diabetes care and prevention.

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Background: Many studies have provided evidence for an increased risk of atrial fibrillation among diabetic patients as compared to the non-diabetic population. It is also well known that diabetes predisposes a person to an increased risk of diabetic nephropathy. A few reviews and studies have hinted towards an increased risk of atrial fibrillation among diabetic nephropathy patients.

Aim: To conduct a meta-analysis to explore if there is an association between diabetic nephropathy and atrial fibrillation.

Methods: The available literature was searched for relevant studies from the period of January 1995 to October 2018. The following quality assessment criterion were considered for study shortlisting: Clearly defined comparison groups, same outcome measured in both comparison groups, known confounders addressed and a sufficiently long and complete (more than 80%) follow-up of patients. Two independent reviewers searched the databases, formed their search strategies and finalized the studies. Data was analyzed to obtain a summary odds ratio along with a forest plot by Cochrane’s RevMan 5.3.

Results: Only four studies were found to meet the inclusion criterion for this meta-analysis (total number of study participants: 307330, diabetic nephropathy patients: 22855). Of these, two were retrospective cross-sectional studies, one was a prospective cohort study and one was a case-control study. Three studies had provided the odds ratio as the measure of effect (two retrospective cross-sectional studies and one case-control study), with the one cohort study reporting the hazards ratio as the measure of effect. Therefore, the meta-analysis was done excluding the cohort study. The summary odds ratio in the present study was 1.32 (0.80-2.18), which was not statistically significant. Due to large heterogeneity among the included studies and their small sample sizes, it was found that the summary estimate shifted towards the null value.

Conclusion: The present meta-analysis found no significant association between atrial fibrillation and diabetic nephropathy. However more studies with large sample sizes are required to strengthen the evidence for an association.

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According to WHO, obesity is defined as an abnormal or excessive fat accumulation that presents a risk to health. It is measured based on the BMI (BMI (kg/m2) =Weight (kg) ÷ Height (m2)) Based on the BMI value people are classified as underweight (<18.5), Normal (18.5-24.9), overweight (25-29.9), obesity (30-39.9) and morbid obesity (40+). The study shows that the main causes of obesity were peoples energy intake was high compared to expenditure which leads to increasing obesity levels. Worldwide obesity has more than tripled since 1975. In 2016, more than 1.9 billion (39%) adults (≥ 18 years) were overweight (39% of men and 40% of women). Of these, over 650 million (13%) were obese (11% of men and 15% of women). Most of the world’s population lives in countries where overweight and obesity kills more people than underweight. 41 million children under the age of 5 were overweight or obese in 2016. In order to reduce the rate of morbid obesity, bariatric surgery is the only effective treatment with long-lasting results. Bariatric surgery leads to a reduction in mortality rates after 5Y, which translates to a decrease in the relative risk of death by 89%. It is also known that obesity is a major risk factor for developing T2DM, with 86% of T2DM patients were either overweight or obese in the UK from this study. Thus, significantly higher diabetes remission rates were reported for gastric bypass (p<0.001) and biliopancreatic diversion (p<0.001) compared to medical therapy. 

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James Joseph has completed his Masters in Engineering Business Management from University of Warwick, UK and has a Degree in Mechanical Engineering from the College of Engineering, Thiruvananthapuram.

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Background: Diabetes is a chronic, progressive disease characterized by elevated levels of blood glucose. Poorly managed diabetes leads to serious complications and early death. The prevalence of diabetes has been increasing over the past few decades. Ethiopia is one of African countries with the highest number of people living with diabetes. Studies conducted in Ethiopia and other countries mainly focused on level of glycemic control at one point in time. Studies targeting the time that a patient stayed in a poor glycemic level are lacking.

Objective: To estimate time to fi rst optimal glycemic control and to identify prognostic factors among Type-2 Diabetes Mellitus (T2DM) patients in public teaching hospitals in Addis Ababa, Ethiopia.

Methods: A hospital based retrospective chart review study was conducted from April to July 2018 at diabetes clinic of Addis Ababa’s public teaching hospitals among randomly selected sample of 685 charts of T2DM patients who were on follow up from January 1, 2013 to June 30, 2017. Data was collected using pretested data abstraction tool. Data was checked, coded and entered to Epi-Info V.7.2.1.0 and exported to SPSS V.23.0 and STATA V.14.1 for analysis. Descriptive statistics is presented with frequency tables, KaplanMeier plots and median survival times. Association was done using Log-rank test and Cox proportional hazard survival model, where hazard ratio, P-value and 95% CI for hazard ratio were used for testing signifi cance and interpretation of results.

Results: Median time to fi rst optimal glycemic control among the study population was 9.5 months. Th e major factors that aff ect it are age group (HR=0.635, 95% CI: 0.486-0.831 for 50-59 years, HR=0.558, 95% CI: 0.403-0.771 for 60-69 years and HR=0.495, 95% CI: 0.310-0.790 for ≥70 years), diabetes neuropathy (HR=0.502, 95% CI: 0.375-0.672), more than one complication (HR=0.381, 95% CI: 0.177-0.816), hypertension (HR=0.611, 95% CI: 0.486-0.769), dyslipidemia (HR=0.609, 95% CI: 0.450-0.824), cardiovascular disease (HR=0.670, 95% CI: 0.458-0.979) and hospital patient treated at (HR=1.273, 95% CI: 1.052-1.541).

Conclusion: Median time to first optimal glycemic control among T2DM patients is longer than expected which might imply that patients are being exposed to more risk of complication and death.

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