2018 ADEA-WA Branch Conference
|Program 5 April|
|Program 6 April|
|6.00-7.30pm – Flash Glucose Monitoring Workshop sponsored by Abbott Diabetes Care|
|8.00-9.30am – Registration|
|8.30-8.35am – Welcome by Branch Chair|
| 8.35-9.20am – Closed Loop Therapy for Type 1 Diabetes: Update
Most patients with Type 1 Diabetes do not achieve acceptable glycaemic control especially the young, all are at risk of hypoglycaemia and for many, the burden of care is high and results in significant stress for both the patient and family. Advances in technology have offered promise to address these problems through automated insulin delivery. The artificial or mechanical pancreas uses a combination of continuous glucose sensing, an insulin pump and a control algorithm to keep blood glucose levels at a target level. Rapid progress has been made over the last 10 years and these systems have proven safe and effective in hospital studies and early outpatient trials. These trials have demonstrated reduced hypoglycaemia and more time spent in an optimal glucose range. Early models have been “hybrid” that is they still require a bolus to be given for food intake. In 2016 the first commercial device was approved by the FDA and will be released in 2017 in the USA. Other systems are in development. There remain challenges such as food and exercise and it is not yet known how patients will manage these devices in the real world but despite the challenges it is likely that diabetes treatment will be revolutionised over the next decade.
|Professor Timothy Jones, University of Western Australia|
| 9.20-10.05am – Counting the Fat, Protein and Carbs – Translating the Evidence into Clinical Practice
At present, individuals with type 1 diabetes typically calculate the meal-time insulin dose using an individualised insulin-to-carbohydrate ratio. However, there is increasing evidence that the glycaemic impact of dietary fat and protein should be considered when determining the meal-time insulin dose and how it is delivered. Protein and fat have been shown to independently and additively cause postprandial hyperglycaemia in children and adults using intensive insulin therapy. Large quantities of protein eaten alone results in significantly delayed and sustained postprandial glycaemic excursions. The addition of protein to a carbohydrate meal decreases the early postprandial glucose level and then increases late postprandial glucose in a dose dependent manner. Currently, there are no published clinical guidelines describing the optimal timing and split of the insulin bolus to account for the fat and protein content. A recent study by our group found a combination bolus with at least 60% of the dose upfront was required to control the initial postprandial rise, with additional insulin of up to 30% needed in the extended bolus to prevent delayed hyperglycaemia. Novel mealtime insulin dosing algorithms have been developed to account for the glycaemic impact of meal fat and protein content. However, significant inter-individual variation in insulin requirements for fat and protein means an individualized approach to insulin dosing is advised. Diabetes education will remain the key to the successful translation of new methods of insulin dosing into the daily lives of people living with type 1 diabetes.
|Dr Carmel Smart, John Hunter Children’s Hospital, Newcastle|
|10.35-11.20 – Concurrent Sessions
Technology and Diabetes (via video conference)
There is no doubt that technology and innovation continue to have a growing impact on diabetes care and offer us solutions that are transformative in the way self-management care is delivered. With the growing adoption of e-Health solutions, there is a real potential for accelerated change in diabetes healthcare and opportunities to overcome barriers of the past. For people with diabetes, the use of technology can translate to fewer clinic and emergency visits, reduced episodes, and duration of hospitalisations, decreased travel time and expense and increased service access particularly for the aged, disabled and living in rural areas. For clinicians, using technology can lead to enhanced clinical outcomes, more informed decision making, greater efficiency and the expansion of outreach services. However, the integration of newer technologies poses challenges to the traditional models of service delivery and demands that our industry evolve to meet the varying needs of people living with diabetes. To not only survive but to thrive in delivering better services, we need to be aware of what technology tools are available to us as healthcare professionals and understand and integrate technologies into our work and do this in a way that directly draws on the needs of the individual living with diabetes. This session will be fun and interactive and explore real-world opportunities for the use of technology in diabetes self-management and care through case studies and audience discussion.
The Impact and Importance of Vascular Calcification in Patients with Diabetes Mellitus
Vascular calcification is a poorly understood disease process involving hardening of the arteries. Worsening vascular calcification leads to poorer elasticity of the arteries and may precipitate hypertension, cardiac hypertrophy or even heart failure. There is a very strong association between the severity of coronary artery calcification and the likelihood of suffering a myocardial infarction. People with diabetes mellitus suffer a more severe form of vascular calcification. There is no current treatment for vascular calcification and such a treatment may be beneficial in reducing the risk of cardiovascular disease in people with diabetes mellitus.
|Natalie Wischer, National Association of Diabetes Centres
Dr Jamie Bellinge, Department of Health, WA
| 11.20am-12.05pm – Diabetes in Pregnancy: NDSS Initiatives to Support Women Before, During and After Pregnancy
The National Diabetes Strategy states that approximately 12-14% of pregnant women in Australia are diagnosed with gestational diabetes1, while the AIHW reports that 10 in 1000 births are to women with pre-existing type 1 or type 2 diabetes2. Evidence indicates that the number of women with all forms of diabetes in pregnancy is increasing3, with the prevalence of GDM now reported to be as high as 30% in some regions of Australia4. Women with diabetes require additional support during pregnancy. However, the planning, management and postnatal care needs of pregnant women differ depending on the type of diabetes. Diabetes in pregnancy is a priority area for the National Diabetes Services Scheme (NDSS). This presentation will summarise the latest NDSS data on gestational diabetes, as well as key findings from the NDSS Contraception, Pregnancy & Women’s Health Survey (2015) which gathered information on preconception counselling and care provided to Australian women with pre-existing diabetes. NDSS initiatives to support women before, during and after pregnancy, will be presented.
|Dr Melinda Morrison, Diabetes NSW|
|12.05-1.00pm – Lunch and Poster Presentations|
|1.00-1.45pm – Oral Abstracts
Oral Stream A (Clinical Research/ Research into Practice)
Oral Stream B (Rural/ Telehealth/ Education)
|1.45-2.30pm – The Long Term Impact of Diabetes in Pregnancy
The proportion of women with pregnancy complicated by either gestational or pregestational diabetes is increasing. This relates both to recent changes in the diagnostic criteria for gestational diabetes and to lifestyle factors contributing to increasing prevalence of obesity. In addition the incidence of type 1 diabetes is increasing. This talk will explore implications of diabetes in pregnancy on maternal long term health and on health of the offspring. Epigenetic chromosomal changes which mediate many of these effects can hopefully be at least partially avoided by good pre-pregnancy and pregnancy care optimising glycemic control and avoiding excess maternal weight gain in pregnancy.
|Dr Dorothy Graham, Obstetric Physician|
|3.00-3.45pm – CDE Panel : Wish We Knew Then What We Know Now
(Chaired by Glenn Cardwell, APD)
|Jaimee Paniora, Annette Hart, Nicole Frayne and Andrea Gilbey|
|3.45 -3.55pm – Awards Presentation|
|3.55-4.00pm- Conference wrap up, evaluation and close|
|4.00-4.45pm – ADEA-WA Branch Meeting|
|5.00-6.30pm – Meet and Greet Cocktail Function (included in ticket cost). No specific theme. Smart casual dress code.|