International Conference on Diabetes and Diabetic Nursing Care September 20-21, 2017 Charlotte, North Carolina, USA

C Poojitha Reddy is a final year (part 1) Student at Kurnool Medical College, Kurnool. She has participated in National Science Congress and won 1st place for her presentation on Biodiversity. In NCC, she has been selected as “Best cadet of Andhra Pradesh 2010” and received award from Prime Minister of India

Background & Aims: Type 2 diabetes is a heterogeneous group disease with variable degree of insulin resistance and insulin deficiency. Intensified insulin therapy [IIT] with pre-prandial regular insulin and long acting insulin overnight is superior to conventional insulin therapy (CIT) with pre-mixed regular and long acting insulin twice a day for glycemic control.

Materials & Methods: 606 type 2 diabetes patients with insulin resistance, aged 40-50 years, duration of diabetes 5-6 years and taking insulin are taken up for the study from the daily O.P. of Diabetes research center, Sainagar, Anantapur, AP, India, from March 2016 to June 2017. Patients with two or less injections per day are regarded as CIT and more than 2 insulin injections per day as IIT. BP, body weight, BMI, HbA1c are studied at the beginning of the study and 6 months later.

Results: CIT- n=167, IIT- n=439 patients receiving CIT at baseline had lower weight (p<0.05), BMI (<0.05) and BP (P<0.05). At reexamination after 6 months both groups had significantly lower HbA1c (p<0.001) body weight (p<0.001) and BMI(p<0.001), BP control was significant in patients with IIT (p<0.001)

Conclusion: Metabolic control in terms of HbA1c does not differ between IIT and CIT but BP control and quality of life was significantly better in patients receiving IIT.

Ranga Raj Dhungana has implemented HIV/STI related projects for more than 15 years. He has continued his expertise through academic institutions and health projects after completion of PhD in public health from Sri Lanka. He established an Integrated School Health Program (ISHP) for Disaster Emergency Preparedness(DEP), Mobile Health Camp(MHC), First Aid Management and Referrals(FAMR), and Child Mental Health Support(CMHS) in Nepal in 2015. Beside these, he provided technical support in implementation of research project/s related to Reproductive Health and Rights (RHR) and Nutrition. He has also initiated to establish an international partnership program related to Management of Communicable and Non-Communicable Diseases like Diabetes.

Statement of Problem: Nutritional status of children under five in Nepal is very poor. The 2011 NDHS found 29% underweight and 11% wasted. USAID reported 40% stunting and 60% stunting with deficiencies of diarrheal disease with effects of nutritional status, 49% households have access to food year-round. However, 12% households are mildly food insecure, 23% moderately, and 16% severely. Rural households insecure 46% as compared to urban 67%. Th e purpose of this cross-sectional study was to identify assess of household food security and nutritional status of children aged essential dietary components, and 44% population does not access to toilets that contribute to morbidity of 1-5 years in Dhading.

Methodology: Data among 172 paired caregivers and children collected. Anthropometric measurements of children, face-to-face interviews of caretakers and household food security using HFIAS module questionnaire were measured. Data were analysed by using Pearson’s chi square test and Fisher’s exact test.

Finding: Th e prevalence was 30.2% underweight, 20.3% stunting and 8.1% wasting determined by applying 2006’s WHO growth chart in Dhading. Moderate food insecurity was 45.9% and 15.2% severe food insecurity, where normal and healthy food-plan for under 5 children with diabetes were not available.

Conclusion & Significance: Mother’s education and family income had a significant association with underweight of a child. Many predominant factors that attribute leading to the vicious cycle for the prevalence of under nutrition, which are the socio-economic and educational status. If these conditions are taken meticulously with healthy food-plan, the consequences of nutrients’ defi ciencies and risk of diabetes can be well-prevented. Thus, household food security, well nutritional status, and appropriate nursing care can be strengthening by adopting “Integrated School Health Program (ISHP)” that can facilitate to create awareness for establishment of regular eating patterns, food-plan among under 5 children with diabetes, and nursing care interlinkage.

Uneeba Syed has done her MBBS from National University Of Science and Technology (NUST) Pakistan. She has done her FCPS in Medicine and FCPS endocrinology. She is also a CRCP qualifi ed. She is presently working as a Consultant Medical Specialist and Endocrinologist in a renowned government hospital of Pakistan.

Background: The use of syringes, needles and lancets is common in every diabetic patient whether for blood glucose monitoring or for insulin treatment. Most hospitals follow well-established guidelines regarding sharps disposal. However, in the community, improper disposal of needles and syringes is common leading to needle stick injuries and predisposing domestic waste handlers, ragpickers and the general community at high risk of communicable diseases like hepatitis B, C and HIV.

Objectives: Th e objective of this study is to determine the knowledge, attitude and behavior of diabetic patients related to disposal of used needles and syringes and the eff ect of counselling on these practices.

Methods: A cross-sectional, interventional study was conducted on 300 diabetic subjects attending a tertiary care hospital in Lahore by means of a structured 20-point questionnaire and standardized interview in appropriate community language. Data was analyzed using spss20inc. Study participants were counselled about safe sharps disposal and instructed to bring all used needles and syringes in puncture-resistant closed container on their next DMC visit.

Results: Out of 300 patients 131 (43.6%) were male and 169 (56.3%) were female. 107 (35.6%) were illiterate, 186 (63%) were unemployed and 111 (37%) were employed. 7 (6%) had hepatitis B, 20 (23%) had hepatitis C and 3 (1%) had HIV. 296 (99%) had no knowledge about proper disposal. Irrespective of any factor, 285 (95%) of the patients were throwing the sharps in dustbins, 3(1%) in the toilets, 7 (2%) outside and 6 (2%) elsewhere. 180 (60%) patients brought back the needles in boxes whereas 118 (39.3%) did not

and 2 (0.6%) were lost to follow-up.

Conclusion: Th is study revealed that diabetic subjects attending the tertiary care hospital in Lahore, Pakistan have little knowledge of the importance of safe sharps disposal or of the risk of transmissible diseases resulting therefrom and had also not received any instructions. Th ere was a change in the attitude and practice following counselling. Interventions to increase awareness about importance of proper sharps disposal among the diabetic population are needed. It is therefore recommended that specific health education regarding sharps disposal be routinely given to diabetic subjects.

Nyane N A has completed her BPharm Degree from University of Lesotho. She has enrolled in her studies at University of KwaZulu-Natal where she is currently doing her research under the department of Pharmacology, School of Health Sciences. She was awarded fi rst prize (30000-travel voucher) in research symposium 2016 for winning in the Masters oral category held by College of Health sciences. She has assisted the Honors students with their Laboratory Experiments. She is lecturing on third level and fourth level at University of KwaZulu-Natal in school of Pharmacy. She has two accepted manuscript in Journal of Pharmacology and the other is PLOS ONE.

Type 2 diabetes (T2D) is characterized by impaired insulin secretion and peripheral insulin resistance. Despite many classes of drugs available, T2D is still projected to increase by 55% in 2035. Citrus fruit-derived fl avonoid, naringenin has been reported to have antidyslipidemic, anti-oxidant and more recently metformin-like antidiabetic eff ects. Metformin, the most commonly used drug for T2D management acts by activating adenosine monophosphate activated protein kinase (AMPK). Naringenin’s anti-diabetic effects could be mediated by AMPK activation. Although naringenin has been shown to have anti-diabetic properties, it is less lipophilic and has poor water solubility hence chalco-naringenin analogs with enhanced pharmacological activities were synthesized. A series of 11 compounds of 4-[(cyclopropylcarbonyl) amino] chalco-naringenin analogues were synthesized using Claisen-Schmidt and characterized by IR, 1H-NMR and 13 C-NMR. An intermediate compound, N-(3-acetylphenyl) cyclopropanecarboxamide synthesized was reacted with commercially available aldehydes to yield the fi nal amino-chalco-naringenin series. Th e synthesized compounds showed characteristic peaks on IR, 1H-NMR and 13 C-NMR and fi t very well in the hydrophobic binding pockets of

AMPK. Th ey also presented good binding affi nity to the enzyme as shown by computer simulation suggesting potential metforminlike antidiabetic eff ects. Further, in vitro and in vivo antidiabetic studies are suggested to elucidate the molecular mechanisms of these compounds.

Introduction: Diabetes mellitus is a group of metabolic disorders characterized by hyperglycaemia resulting from impaired insulin secretion or defective insulin or both.

Study objective: Th e objective of this study is to investigate the consumption patterns, knowledge, barriers and benefi ts of compliance to diabetes dietary plans among black Zimbabweans receiving diabetes education from traditional and/or the western public health system.

Design: A multiple case study research design was used. Data on frequency and quality of food consumption, beverage use was collected using three 24-hour diet recalls and a food frequency questionnaire while knowledge of diabetes prevention and self care seeking behaviours was sought using the Simplifi ed Diabetes Knowledge Scale (n=10 women and 14 men). In-depth interviews were used to gain insights regarding participant feelings and beliefs about the disease. Weight, height and blood pressure were collected by trained specialists.

Study setting: An urban suburb of Mucheke in Masvingo and a rural area of Bikita.

Results: Reported dietary data on frequency of consumption showed that urban patients had at least three to four meals per day. A grazing eating pattern was observed in terms of the snacking habits among urban participants with fruit juice, whole wheat bread, roast corn, and fruits (apples and bananas) among the most frequently used snacks. In terms of calorie intakes, consumption of dietary fat was higher than recommended for the urban group. Use of ultra processed and animal protein was higher in urban areas while carbohydrate intakes were higher in rural than urban areas. Obesity was prevalent among 13-16% of men compared to 34% for women. In relation to T2D treatment, majority of the patients used both traditional medicine and western biomedicine. Dietary advice varied from one professional to the other.

Conclusion: Glucose control was poor among the participants. Th e level of diabetes knowledge of complications, risk factors and preventive self care management practices was low. Patient levels of self effi cacy related to patient confi dence regarding eff ectiveness of health seeking behaviours was poor. To that end, the study recommended for more empowering diabetes education protocols.

Adegbenga B Ademolu is an Associate Fellow of the National Postgraduate Medical College of Nigeria. He works in the department of Medicine of Lagos State University Teaching Hospital Ikeja, Lagos Nigeria. He is a Member of the Endocrine Society, where he functions as a Reviewer for both the Journal of Clinical Endocrinology and Metabolism (JCEM) and Journal of the Endocrine Society (JES). He is also a Fellow-in-Training of the American Association of Clinical Endocrinologist. He is in the Editorial Board of the journal Gastroenterology and Liver: Clinical and Medicals (GLCM). His work on hypoglycemia amongst others is opening new path of scientifi c knowledge and research in Endocrinology and related fi eld. He has presented papers locally in Nigeria and internationally at conferences and has published papers locally in Nigeria and internationally in American, European and Asian journals. He is an Active Member of the Endocrine and Metabolism Society of Nigeria.

Hypoglycemia as a management complication of diabetes mellitus (DM) is a worldwide experience. In Africa, hypoglycemia is an uncharted territory in literature. Th erefore, the following questions will be addressed using Ademolu’s Classifi cation of Hypoglycemia (ACH). Which is the commonest and the least common grade of hypoglycemia in D M African patients? Which grade of hypoglycemia is seen commonly in type 1 and in type 2 diabetics? Th is is a retrospective study that analyses 203 (two hundred and three) documented hypoglycemic episodes in Africans with DM admitted between July 2007 and October 2016 in Lagos State University Teaching Hospital, Lagos Nigeria using a questionnaire on 50 case fi les studied. Hypoglycemia was defi ned as a blood sugar of 70 mg/dl or less. Th e age range of the patients was 18 to 95 years. Now, by using ACH to analyze the 203 hypoglycemic episodes in all type 2 diabetics studied, 48.50% had grade l hypoglycemia, 35.93% had grade 2 hypoglycemia while 15.57% had grade 3 hypoglycemia. In all type 1 DM studied, 30.50% had grade 1, 33.33% had grade 2 while 36.11% had grade 3 hypoglycemia. The lowest documented hypoglycemia amongst type 2 DM was an asymptomatic fasting blood sugar of 20 mg/dl (grade 3 hypoglycemia). By using ACH, there was no record of grade 4 hypoglycemia in both type 1 and type 2 DM patients in this African study. The commonest grade is grade 1 (mild) in type 2 DM, whereas grade 3 (severe) is the commonest in type 1 DM. Th e least common grade of hypoglycemia in type 2 DM is grade 3 while in type 1 DM, it is grade 1. Asymtomatic hypoglycemia can occur in grade 3 among African diabetics. A similar study is recommended in Americans, Europeans, Asians and all ethnic groups for possible racial diff erences or disparity in the fi ndings of this research.