Category: Diabetes/Prediabetes/Hypoglycemia

Monitor: 12

12 - COMMUNITY TO CLINIC TO BENCH: BIOMARKER ASSOCIATIONS FOR BETTER DIABETES HEALTH CARE - FOUNDATION STUDIES

Thursday, Apr 25
11:00 AM – 11:30 AM

Objective :

There is an imminent need to identify and elucidate additional novel biomarkers and point of care[POC] devices, which have the potential to facilitate several specific aspects of diabetes prevention, management and complications reduction. 


Methods :

I. Establishment of a robust cohort [Current N= 1196; Non diabetes= 119, Type 1 DM= 260, T2DM= 817] of well characterized patients with diabetes, to facilitate longer term longitudinal studies.


II. Evaluation of Conventional Diabetes Biomarkers: Hemogram; Blood glucose: Fasting / Post Prandial; Serum creatinine / eGFR; Serum lipid profile; Urine albumin: creatinine ratio.


III. Comparison of Standard “laboratory” assays versus “Point of Care” measurements: POC Studies: Hb: Hemoglobin; HbA1c: Glycated hemoglobin; SA: Serum Albumin; UA: Urine Albumin; UC: Urine Creatinine; Urine Albumin : Creatinine ratio.


IV. Examination of Correlations between “Clinical” and “Laboratory” biomarkers: Clinical significance, implications and utility: Glycemic control; Hypoglycemia; Nephropathy and kidney disease; Anemia; Cardiovascular risk factors and disease.


Results :

Biomarker correlations:


“Higher HbA1c” was significantly: (a) “positively” correlated with urine albumin : creatinine ratio [nephropathy], eGFR - estimated glomerular filtration rate [hyperfiltration], serum total cholesterol and serum triglycerides [poor glycemic control]; and (b) “negatively” correlated with serum albumin [nephropathy - albuminuria] and serum creatinine [preexisting impaired renal function, tight glycemic control and hypoglycemia].


“Higher urine albumin : creatinine ratio” was significantly: (a) “positively” correlated with HbA1c [poor glycemic control], serum creatinine [impaired renal function]; and (b) “negatively” correlated with hemoglobin [anemia of CKD], serum albumin [nephropathy – albuminuria] and eGFR [higher CKD grades].


“Laboratory” Biomarkers – Laboratory Gold Standard versus Point of Care POC: Statistical analyses showed significant correlation and agreement between the Laboratory Gold Standard and PoC assays [HbA1c, Hb, Serum Albumin, Urine Albumin and Urine Creatinine].


Discussion :

Diagnosing and early detection of chronic diseases in remote and resource challenged settings is difficult without access to costly well-equipped clinical laboratories and trained medical personnel. 


Conclusion : Consequently, developing POC diagnostics for chronic conditions [eg diabetes and its complications like kidney disease] that are cost effective and can be easily implemented, remains an important goal in global health. 

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Jayalakshmi T

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
Bangalore, Karnataka, India

Designation: Consultant and Faculty

Specialties: Endocrinology, Diabetes, Internal Medicine,
Clinical Interests: Diabetes mellitus, Cardiovascular Health, Thyroid, In Patient Diabetes Care, Endocrinology Metabolic emergencies and critical care

Reshma B. Vijay

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
Bangalore, Karnataka, India

Designation: Consultant and Faculty
Specialties: Endocrinology Diabetes and Metabolism
Clinical Interests: Pediatric Endocrinology; Diabetes mellitus; Insulin Pumps, Continuous Glucose Monitoring and Artificial Pancreas; Growth and Puberty; Thyroid; Pituitary Adrenal disorders

Vasanthi Nath

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
Bangalore, Karnataka, India

Designation: Consultant and Faculty
Specialties: Endocrinology, Diabetes, Internal Medicine, Geriatrics
Clinical Interests: Neuroendocrinology and Neurometabolism, Metabolic Myopathies; Thyroid tumors, Geriatric Endocrinology, Inpatient Diabetes Care and Endocrine Emergencies; Type 1 diabetes across ages

Muralidhara Krishna

Consultant Faculty Endocrinology Diabetes Biochemistry
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
Bangalore, Karnataka, India

Designation: Consultant and Faculty: Endocrinology Diabetes Metabolism; Associate Professor: Clinical Biochemistry and Laboratory Medicine
Specialties: Endocrinology Diabetes Metabolism; Clinical Biochemistry
Clinical Interests: Diabetes mellitus; Thyroid Disorders; Obesity; Dyslipidemia.

Kavitha Muniraj

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
Bangalore, Karnataka, India

Designation: Consultant and Faculty; Director Medical ; Director Research; Trustee
Specialties: Endocrinology Diabetes; Clinical Research
Clinical Interests: Pituitary Adrenal disorders; Bone health; Cardiovascular Health; Thyroid dysfunction; Diabetes Pharmacotherapy; Clinical Pharmacology; Pharmacovigilance; Clinical research Safety and Audits

Babitha D. T

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
Bangalore, Karnataka, India

Designation: Consultant and Faculty
Specialties: Endocrinology, Diabetes
Clinical Interests: Endocrine disorders of pregnancy, Pregnancy Diabetes, Cardiovascular Health, Thyroid, Inpatient diabetes care and endocrine metabolic emergencies

Chandraprabha S

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
Bangalore, Karnataka, India

Designation: Consultant and Faculty
Specialties: Endocrinology Diabetes Metabolism
Clinical Interests: Pregnancy Diabetes, Pregnancy Thyroid Dysfunction, Women Health, Geriatric Endocrinology, Diabetes mellitus and Mental Health, Spiritual Medicine

Nidhi Garg

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
bangalore, Karnataka, India

Designation: Senior Consultant and Faculty
Specialties: Diabetes and Metabolism
Clinical Interests: Comprehensive diabetes care, In-patient diabetes and metabolic care, Perioperative diabetes management, Diabetes and endocrine emergencies – Metabolic Intensive Care, Obesity management, Lipids and preventive cardiology, Gestational diabetes, Thyroid disorders, Type 1 diabetes across ages

Apoorva Govind

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center
bangalore, Karnataka, India

Designation: Resident
Specialties: Endocrinology, Diabetes, Internal Medicine, Pediatrics
Clinical Interests: Diabetes mellitus, Cardiovascular Health, Thyroid, Pediatric Diabetes Endocrinology

Madhumati S Vaishnav

Scientist Faculty
Jnana Sanjeevini Diabetes Hospital and Medical Center; CENSE Indian Institute of Science
bangalore, Karnataka, India

Scientist Faculty, MSc, CDE, PA, [PhD], Jnana Sanjeevini Diabetes Hospital and Medical Center; CENSE Indian Institute of Science, Bangalore, India

MD Chitra

Consultant Faculty Endocrinology Diabetes
Samatvam Jnana Sanjeevini Diabetes Hospital and Medical Center

Designation: Consultant and Faculty; Trustee
Specialties: Endocrinology Diabetes; Clinical Research
Clinical Interests: Diabetes, Obesity, Dyslipidemia, Osteoporosis, Pituitary Adrenal disorders; Bone health; Cardiovascular Health; Thyroid dysfunction;

Vasudha Srikanth


India

Monica Narayanaswamy

Resident doctor
Samatvam jnana sanjeevini diabetes hospital and medical centre
Chintamani, India

Nalini Rayas

Keerthana Haridas

Namya Gaekwad

Sri Srikanta