Day 2-Conference Coverage

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Dr. Kim Jebodsingh giving her presentation on Day 2 of the conference.

Day 2 was a combination of topics which included “Fertility Issues in Diabetes”, Diabetes and Its Affects on the Eye, “The Role of Testosterone in Sexual Dysfunction in Men With Diabetes” and “Reversing Diabetes in Barbados”.

Quick Look at Topics of the Day

Fertility & Diabetes 

Dr. Roberta Corona from the The Fertility Clinic in Barbados gave a brief presentation on some of the many issues women with diabetes face when seeking to start a family. One of the major talking points were PCOS (Polycystic Ovarian Syndrome).  According to Diabetes.org, “5 to 10 percent of women in the U.S. have this syndrome” and as a result there can be fertility issues.  Dr. Corona outlined that some of the reasons for this condition includes “hormonal imbalance, high levels of testosterone” and health complications like “high blood pressure, cholesterol, insulin resistance and obesity” which are classic elements of “metabolic syndrome”.  A women with diabetes at child bearing age, this pose a threat to their life for “heart attack and stroke”.

According to Mayo clinic, diagnosis of metabolic syndrome

“Several organizations have criteria for diagnosing metabolic syndrome. According to guidelines used by the National Institutes of Health, you have metabolic syndrome if you have three or more of these traits or are taking medication to control them:

  • Large waist circumference — a waistline that measures at least 35 inches (89 centimeters) for women and 40 inches (102 centimeters) for men
  • High triglyceride level — 150 milligrams per deciliter,(mg/dL), or 1.7 millimoles per liter (mmol/L), or higher of this type of fat found in blood
  • Reduced high-density lipoprotein (HDL) cholesterol — less than 40 mg/dL (1.04 mmol/L) in men or less than 50 mg/dL (1.3 mmol/L) in women of this “good” cholesterol
  • Increased blood pressure — 130/85 millimeters of mercury (mm Hg) or higher
  • Elevated fasting blood sugar — 100 mg/dL (5.6 mmol/L) or higher”

 

Dr. Corona ended with the point that “metabolic control can help fertility”.

Prof. Hugh Jones

Erectile Dysfunction (ED) and Diabetes

From Day 1 of the Diabetes Conference, Dr. Hugh Jones’ main theme for his presentation was “link of low testosterone and poor health of diabetic men”.

According to American Diabetes Association, “some men with diabetes have impotence, also called erectile dysfunction (ED). ED is when a man can no longer have or keep an erection”. Dr. Jones highlighted fact that ED and low (T) testosterone count are common problems of men with diabetes.

Low testosterone in (Type 2) diabetic men should be better screened since according to Dr. Jones can be an indicator of coronary heart disease which can lead to death.

“The study was run by a group led by Professor Hugh Jones of Barnsley Hospital NHS Foundation Trust and the University of Sheffield. It analysed data from 581 men with type 2 diabetes at Barnsley Hospital, looking back at their testosterone levels as measured between 2002 and 2005. The patients were then followed up for an average of six years, and mortality rates were compared between men with normal testosterone levels and those with low levels.

The results showed that testosterone levels were on average significantly lower in men who died compared with those who did not, and that the mortality rate was considerably higher in the low testosterone group (17.2%) than in the normal testosterone group.”-NHS UK.

Dr. Jones purported that there is evidence that “testosterone replacement treatment” can have some positive effect, “reducing the death rate in men with Type II diabetes”.

 

Diabetes and The Eye

Dr. Kim Jebodsingh & Ms. Petra Bridgemohan-A look at Diabetes’ Complication-Eye Health

Ophthalmologist Dr. Kim Jebodsingh spoke about “The Many Ways Diabetes can Affect the Eye”. In her presentation, she discussed some of the common conditions she have found in her practice.   She noted the significant signs of deterioration of eye seen in screening of diabetic patients who suffered from stroke. Also, she reported that “80 percent of patients over 60 years has vitreous degeneration”, condition commonly known as “floaters” is not serious however persons with diabetes can have “retinal detachment” (due to vitreous degeneration) which is severe trauma to the eye.

Other serious conditions include “diabetic papillopathy (which is swelling in the eye that can result in visual loss) as well as diabetic retinopathy.  She stated that “99 percent of Type 1 and 60 percent Type 2 have retinal neuropathy”.

On the optometry side, Ms. Petra Bridgemohan spoke about her field in homeland Trinidad and Tobago.  As indicated in T&T media, she explained there is a need for better outreach to patients (particularly those in the rural setting) who are in need of the eye exams and eye care.

Diabetes “Reversal” Study 

Dr. Karen Bynoe, one of the key members of the Diabetes Reversal Study gave her findings on the last day of the 2nd Annual Multidisciplinary Conference.  Here are some of her major finding in the study which lasted for 8 months. It is important that the study would be thought of as “ambitious” to reverse diabetes but found possibility of placing patients’ diabetes in “remission”.

  • There were 25 participants
  • Persons were excluded if they were on insulin
  • Patients were seen weekly, 2 months and at end of the program
  • Communication was face-to-face, in-depth interview, social media (particularly Whatsapp, Facebook)
  • Patients were given nutrition support
  • Persons had to do 150 minutes exercise (moderate/vigorous)

 

The overall results were that participants did lose weight and their blood sugar normalised.   One patient had lost 22 pounds in the 8 week period.  One of the psychological benefits from the exercise was that with the group support and medical attention, persons were highly motivated.

Cons of the Study

Individuals’ main complaint was constipation as they were placed on a restrictive diet which included meal replacement drinks.  Other issues came with cost maintain the diet, which (was mostly natural foods (no processed meals) “costly”, “difficult at time to find healthy foods and social pressures of living in “obesogenic environment”.

The initiative was funded by Virgin Unite and it was a pilot study one of first of its kind to be done in the Caribbean.

 

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