International Conference on Diabetes, Complication & Management November 14-15, 2019 Brisbane, Australia

The term diabetes mellitus describes several diseases of abnormal carbohydrate metabolism that are characterized by hyperglycaemia. It is associated with a relative or absolute impairment in insulin secretion, along with varying degrees of peripheral resistance to the action of insulin. They are derived after doing many clinical trials on animal models. Every few years, the diabetes community revaluates the current recommendations for the classification, diagnosis, and screening of diabetes, reflecting new information from research and clinical practice which in turns help in understanding current prevention and treatment options and cost effectiveness in treatment and prevention of Diabetes.

Diabetes affects almost all the organs in humans. It severely affects the Cardiovascular System and the Urinary system. Also it affects nervous system. Retinopathy is caused by blood vessels in the back of the eye (the retina) swelling and leaking. High blood pressure is also a contributing factor for diabetic retinopathy.Diabetes contributes to high blood pressure and is linked with high cholesterol which significantly increases the risk of heart attacks and cardiovascular disease.Damage to the kidneys takes place over a period of years and can picked up by nephropathy screening before it gets too serious.The presence of nerve damage (neuropathy) is commonly noticed.An alternative cause of disturbed digestion can be the result of diabetes medication.

Diabetes is a chronic disease and its management is associated with multiple challenges. The difficulty is more pronounced in the paediatric age group who has various requirements related to their growth and development. Factors that contribute to difficulties in managing diabetes in children include their status of growth and development, psychological characteristics and social behavior, health status in terms of diabetes control, family dynamics (including life style, socio economic status, and cultural beliefs), and care at nursery and school settings.

Patients with type 2 diabetes more often develop skin infections, whereas those with type 1 more often have autoimmune-related lesions.Insulin signaling supports normal skin proliferation, differentiation, and maintenance, and a lack of insulin may lead to impaired wound healing, which may affect insulin resorption. Skin manifestations of diabetes may also serve as ports of entry for secondary infection.

Diabetic retinopathy progresses from mild nonproliferative abnormalities, characterized by increased vascular permeability, to moderate and severe nonproliferative diabetic retinopathy (NPDR), characterized by vascular closure, to proliferative diabetic retinopathy (PDR), characterized by the growth of new blood vessels on the retina and posterior surface of the vitreous. Macular edema, characterized by retinal thickening from leaky blood vessels, can develop at all stages of retinopathy. Pregnancy, puberty, blood glucose control, hypertension, and cataract surgery can accelerate these changes.

<div style="\&quot;text-align:" justify;\"="">

Gestational diabetes is a type of diabetes that is first seen in a pregnant woman who did not have diabetes before she was pregnant. Some women have more than one pregnancy affected by gestational diabetes. Gestational diabetes usually shows up in the middle of pregnancy. Doctors most often test for it between 24 and 28 weeks of pregnancy.

Gastroparesis is a serious complication of diabetes mellitus (DM), defined as a delay in gastric emptying without any mechanical obstruction in the stomach. Other non-diabetic causes of gastroparesis are surgery, neurologic disorders, medication and idiopathic causes;however, the outcomes for those with diabetic gastroparesis (DGP) are worse. This disorder causes a huge morbidity burden as well as significantly impairing glucose control.

<div style="\&quot;text-align:" justify;\"="">

Insulin degludec seemed to demonstrate a reduction in episodes of hypoglycemia, especially nocturnal hypoglycemia, by approximately 25% compared with insulin glargine, the FDA in its assessment highlighted the fact that this benefit was not a consistent feature seen across the different types of diabetes or definitions of hypoglycemia, in particular the more objective definitions of hypoglycemia .B enefits include flexibility of timing of insulin administration, the lack of weight gain or even weight loss, and some improvement in quality-of-life aspects.

<div style="\&quot;text-align:" justify;\"="">

The global prevalence of "diabesity"-diabetes related to obesity-is increasing steadily over the past few decades because of the obesity epidemic. Although bariatric surgery is an effective treatment option for patients with diabesity, its limited availability, invasiveness, relatively high costs and the potential for surgical and postsurgical complications restrict its widespread use. Therefore, medical management is the only option for a majority of patients with diabesity. Diabetes control with several anti-diabetic agents, including insulin, causes weight gain with probability of worsening diabesity. Rational use of anti-diabetic medications with weight loss potential in varying combinations may help to address this key issue for long-term management of diabesity.

The large multi-centre RCT investigating a dressing that for the first time, according to the manufacturer, generates a sustained release of nitric oxide (NO) on the wound. For this study they recruited patients from 10 diabetic foot clinics across the UK. To be included, patients needed to have a superficial DFU of >2.5cm2 and a palpable pulse or ankle brachial index (ABI) >0.5.Patients were then randomized (by computer) to receive the NO dressing every 2 days (intervention group) or receive a dressing chosen by their treating clinician as often as they needed (control group).

<div style="\&quot;text-align:" justify;\"="">

Drug-induced serum glucose alterations manifested as hyperglycemia or hypoglycemia and ranging from mild to moderate to severe symptoms either appearing acutely or chronically, have perpetual effects on the body, particularly in patients with diabetes. This article and a second one that will appear in the next issue of this journal review drug-induced serum glucose alterations in a two-part series. In this article, we review pertinent clinical information on the incidence of drug-induced hypoglycemia and discuss the underlying pathophysiological mechanisms involved.

<div style="\&quot;text-align:" justify;\"="">

The insulin pump should be given stress that pump use in pregnancy is most successful with a motivated receiver and the involvement of a multidisciplinary team that includes a diabetologist, obstetrician, specialised diabetes nurse, midwife and dietician. If switching prior to pregnancy, most specialists would advocate pump use for at least 3 months before attempting to conceive, in order to achieve stable blood glucose levels and become adept at using the pump. However, it is possible to start a pump during pregnancy if needed.

<div style="\&quot;text-align:" justify;\"="">

Scientists working to develop more effective treatments for diabetes are turning to stem cells. Such cells can be transformed into cells that produce insulin, the hormone that controls blood sugar.Restoration of insulin independence and normoglycemia has been the overarching goal in diabetes research and therapy. While whole-organ and islet transplantation have become gold-standard procedures in achieving glucose control in diabetic patients, the profound lack of suitable donor tissues severely hampers the broad application of these therapies. Here, we describe current efforts aimed at generating a sustainable source of functional human stem cell-derived insulin-producing islet cells for cell transplantation and present state-of-the-art efforts to protect such cells via immune modulation and encapsulation strategies.

<div style="\&quot;text-align:" justify;\"="">

Blood glucose (blood sugar) monitoring is the main tool you have to check your diabetes control. This check tells you your blood glucose level at any one time. The artificial pancreas bridges the gap between two pieces of diabetes technology that already exist: the insulin pump and the continuous glucose monitor (CGM). Relatively, a large percentage of world population is affected by diabetes mellitus, out of which approximately 5-10% with type 1 diabetes while the remaining 90% with type 2. Insulin administration is essential for type 1 patients while it is required at later stage by the patients of type 2. Current insulin delivery systems are available as transdermal injections which may be considered as invasive. Several non-invasive approaches for insulin delivery are being pursued by pharmaceutical companies to reduce the pain, and hypoglycemic incidences associated with injections in order to improve patient compliance.

<div style="\&quot;text-align:" justify;\"="">

Herbal supplements and remedies are used for the treatment of diabetes and hormonal problems such as estrogen and progesterone levels and treatment for menopausal hormone imbalance, etc. These include:Capsaicin cream, a topical ointment made with cayenne, has been reported by some patients to help lower pain in the hands and feet from diabetic neuropathy.Evening primrose oil is thought to help diabetic nerve pain Ginkgo, garlic, holy basil leaves, fenugreek seeds, ginseng, and hawthorn are other herbals that have been promoted by some as remedies for diabetic symptoms.Alternative treatments include Acupuncture, Natural Dietary Supplements, Plant Foods, Natural Remedies for endocrine disorders, Hormonal imbalance cure by medicinal plants, Effects of Herbals in Male impotence & female infertility, Herbals acts on adrenal glands, Support the Endocrine System with Adaptogen Herbs, Avoid Environmental Toxins.

Diabetes is a growing global metabolic epidemic. Current research is focussing on exploring how the biological processes and clinical outcomes of diabetes are related and developing novel biomarkers to measure these relationships, as this can subsequently improve diagnostic, therapeutic and management capacity. The most promising research avenue identified is the detection and quantification of micro RNA. Further, the utilisation of functionalised electrodes as a means to detect biomarker compounds also warrants attention. Biomarkers have also been used to study Novel Urinary Biomarkers for Predicting Renal Prognosis in Patients With Type 2 Diabetes by Glycan Profiling.