This document outlines an agenda and presentation on the pathophysiology, screening, diagnosis and classification of diabetes given at a mini-course in Aswan, Egypt in February 2016. The presentation covers:
1. The normal physiology and definition of diabetes and its chronic hyperglycemia-related complications.
2. The clinical classes of diabetes including type 1, type 2, gestational diabetes and other specific types.
3. The pathophysiology, risk factors, screening and diagnosis of type 1, type 2 and gestational diabetes are discussed in further detail.
4. The goals of the course are to help participants in advance of an upcoming conference on diabetes.
Advances and Management of Diabetes MellitusPratiksha Doke
Diabetes mellitus is an endocrinological and/or metabolic disorder with an increasing global prevalence and incidence. High blood glucose levels are symptomatic of diabetes mellitus as a consequence of inadequate pancreatic insulin secretion or poor insulin-directed mobilization of glucose by target cells. Diabetes mellitus is aggravated by and associated with metabolic complications that can subsequently lead to premature death. This presentation explores diabetes mellitus in terms of its types, causes and management interventions for improved lifestyle for patient.
Advances and Management of Diabetes MellitusPratiksha Doke
Diabetes mellitus is an endocrinological and/or metabolic disorder with an increasing global prevalence and incidence. High blood glucose levels are symptomatic of diabetes mellitus as a consequence of inadequate pancreatic insulin secretion or poor insulin-directed mobilization of glucose by target cells. Diabetes mellitus is aggravated by and associated with metabolic complications that can subsequently lead to premature death. This presentation explores diabetes mellitus in terms of its types, causes and management interventions for improved lifestyle for patient.
Type 2 dm gdm new updates & guidelinesSachin Verma
Type 2 diabetes is a multifactorial disorder characterised by progressive pancreatic beta-cell dysfunction and insulin- resistance, leading to relative insulin deficiency, chronic hyperglycaemia, and various complications.
The treatment options for this disorder, which aim at correcting one or other of the two major pathophysiological mechanisms, have been hamstrung by unacceptable side-effects, lack of patient acceptability, and loss of efficacy over time.
Delivered at the Philippine Academy of Ophthalmology Annual Convention at the EDSA Shangri-la, Manila 2015. Update on Epidemiology, Diagnosis and Treatment of Diabetes in the Philippines.
Diabetes and pregnancy - Endocrine society guidelines 2013Jagjit Khosla
This presentation talks about diabetes mellitus in relation to pregnancy. It classifies diabetes in pregnant pts as overt and gestational diabetes. Then it discusses the various guidelines given by Endocrine Society in 2013 for management of diabetic patients during pregnancy
Type 2 dm gdm new updates & guidelinesSachin Verma
Type 2 diabetes is a multifactorial disorder characterised by progressive pancreatic beta-cell dysfunction and insulin- resistance, leading to relative insulin deficiency, chronic hyperglycaemia, and various complications.
The treatment options for this disorder, which aim at correcting one or other of the two major pathophysiological mechanisms, have been hamstrung by unacceptable side-effects, lack of patient acceptability, and loss of efficacy over time.
Delivered at the Philippine Academy of Ophthalmology Annual Convention at the EDSA Shangri-la, Manila 2015. Update on Epidemiology, Diagnosis and Treatment of Diabetes in the Philippines.
Diabetes and pregnancy - Endocrine society guidelines 2013Jagjit Khosla
This presentation talks about diabetes mellitus in relation to pregnancy. It classifies diabetes in pregnant pts as overt and gestational diabetes. Then it discusses the various guidelines given by Endocrine Society in 2013 for management of diabetic patients during pregnancy
Screening for diabetes and its complications as part of the Alberta Diabetes ...Kelli Buckreus
2004 (Jan) 3rd National Conference on Diabetes and Aboriginal Peoples, National Aboriginal Diabetes Association (NADA), poster presentation by BRAID Research
All what you have to know about Diabetes MellitusYapa
All what you have to know about Diabetes Mellitus is here.Introduction of Diabetes,Regulation of blood glucose,Predisposing factors of DM,Clinical presentation,DM and pregnancy ,Diabetes ketoacidosis ,Complications of DM ,Diagnosis ,Dietary management of DM & Prevention of DM.
Student seminar on Diabetes Mellitus presented by 2007/2008 Batch students of Faculty of Medicine,University of Peradeniya,Sri Lanka.
Classification & Diagnosis of Diabetes.pptx
By Dr. Usama Ragab Youssif
Lecturer of Internal Medicine Zagazig University
Email: usamaragab@medicine.zu.edu.eg, usama.ragab.zu@gmail.com
SlideShare: https://www.slideshare.net/dr4spring/
Facebook: https://www.facebook.com/doc.usama
Facebook Clinic: https://www.facebook.com/usamaclinic
Mobile: 00201000035863
Diabetes mellitus refers to a group of diseases that affect how your body uses blood sugar (glucose). Glucose is vital to your health because it's an important source of energy for the cells that make up your muscles and tissues. It's also your brain's main source of fuel.
With diabetes, your body doesn’t make enough insulin or can’t use it as well as it should. When there isn’t enough insulin or cells stop responding to insulin, too much blood sugar stays in your bloodstream. Over time, that can cause serious health problems, such as heart disease, vision loss, and kidney disease.
This talk was delivered for postgraduates and faculty of Dr. TMA Pai Hospital, Udupi on 07 March, 2017. This talk covered pathophysiology, screening, diagnosis, complications and management of diabetes mellitus in pregnancy.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
Recomendações da OMS sobre cuidados maternos e neonatais para uma experiência pós-natal positiva.
Em consonância com os ODS – Objetivos do Desenvolvimento Sustentável e a Estratégia Global para a Saúde das Mulheres, Crianças e Adolescentes, e aplicando uma abordagem baseada nos direitos humanos, os esforços de cuidados pós-natais devem expandir-se para além da cobertura e da simples sobrevivência, de modo a incluir cuidados de qualidade.
Estas diretrizes visam melhorar a qualidade dos cuidados pós-natais essenciais e de rotina prestados às mulheres e aos recém-nascidos, com o objetivo final de melhorar a saúde e o bem-estar materno e neonatal.
Uma “experiência pós-natal positiva” é um resultado importante para todas as mulheres que dão à luz e para os seus recém-nascidos, estabelecendo as bases para a melhoria da saúde e do bem-estar a curto e longo prazo. Uma experiência pós-natal positiva é definida como aquela em que as mulheres, pessoas que gestam, os recém-nascidos, os casais, os pais, os cuidadores e as famílias recebem informação consistente, garantia e apoio de profissionais de saúde motivados; e onde um sistema de saúde flexível e com recursos reconheça as necessidades das mulheres e dos bebês e respeite o seu contexto cultural.
Estas diretrizes consolidadas apresentam algumas recomendações novas e já bem fundamentadas sobre cuidados pós-natais de rotina para mulheres e neonatos que recebem cuidados no pós-parto em unidades de saúde ou na comunidade, independentemente dos recursos disponíveis.
É fornecido um conjunto abrangente de recomendações para cuidados durante o período puerperal, com ênfase nos cuidados essenciais que todas as mulheres e recém-nascidos devem receber, e com a devida atenção à qualidade dos cuidados; isto é, a entrega e a experiência do cuidado recebido. Estas diretrizes atualizam e ampliam as recomendações da OMS de 2014 sobre cuidados pós-natais da mãe e do recém-nascido e complementam as atuais diretrizes da OMS sobre a gestão de complicações pós-natais.
O estabelecimento da amamentação e o manejo das principais intercorrências é contemplada.
Recomendamos muito.
Vamos discutir essas recomendações no nosso curso de pós-graduação em Aleitamento no Instituto Ciclos.
Esta publicação só está disponível em inglês até o momento.
Prof. Marcus Renato de Carvalho
www.agostodourado.com
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
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Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
Ueda 2016 2-pathophysiology ,classification & diagnosis of diabetes - khaled el hadidy
1. Pathophysiology, Screening,
Diagnosis & Classification Of Diabetes
UEDA Diabetes Mini-Course
Aswan Feb. 2016
DR. Khaled El Sayed El Hadidy. MD
Professor of Internal Medicine
Head of Internal Medicine Department
Head of Diabetes and Endocrinology Unit
Beni - Suef University.
UEDA ( IDF member )
11. Clinical classes of diabetes:
1. Type 1 diabetes – results from B cell destruction due to an
autoimmune process usually leading to insulin deficiency.
2. Type 2 diabetes – results from a progressive insulin secretory
defect on the background of insulin resistance.
3. Gestational diabetes mellitus (GDM) – any degree of glucose
intolerance with onset or first recognition during pregnancy.
4. Other specific types of diabetes – due to other causes such as
genetic defects in Beta cell function, genetic defects in insulin
action, diseases of the exocrine pancreas (e.g. cystic fibrosis), and
drug- or chemical-induced causes (e.g. in the treatment of
HIV/AIDS or after organ transplantation).
20. Incretins
Intestine Secretion Insulin = Incretin
Incretins are insulinotropic substances
released by the GIT.
Incretins account for approximately 20%–60%
of insulin secretion after a meal in normal
individuals.
~90% incretin activity is due to:
Glucagon-Like Peptide-1 (GLP-1)
Glucose-dependent insulinotropic
polypeptide (GIP).
21. L L L
GLP-1 GLP-1 GLP-1
InsulinGlucagon
Slowed gastric
emptying
Early
Satiety
Inactive
GLP-1
DPP-4
enzyme
GLP-1
22. Incretin Effect in Subjects without and with
Type 2 Diabetes Given Glucose by IV and Orally
Time, min
IRInsulin,mU/L
nmol/L
0.6
0.5
0.4
0.3
0.2
0.1
0
80
60
40
20
0
18060 1200
Control Subjects
(n=8)
Patients with Type 2 Diabetes
(n=14)
Time, min
IRInsulin,mU/L
nmol/L
0.6
0.5
0.4
0.3
0.2
0.1
0
80
60
40
20
0
18060 1200
Oral glucose load Intravenous (IV) glucose infusion
Incretin
Effect
Nauck M et al., Diabetologia 1986; 29:46–52
24. SCREENING & DIAGNOSIS
SD1 Each health service should decide whether to have
a program to detect people with undiagnosed
diabetes.
Universal screening for undiagnosed diabetes is
not recommended.
SD2 Detection programs are usually based on a two-step
approach:
Step 1 Identify high-risk individuals using a risk
assessment questionnaire.
Step 2 Glycemic measure in high-risk individuals.
25. Individuals Considered To Be At High
Risk Of Type 2 Diabetes
People with IGT or IFG
All patients with a history of a cardiovascular event (acute
myocardial infarction, angina, peripheral vascular disease or
stroke)
People aged 35y and over originating from the Pacific
Islands, Indian subcontinent or China
People aged 40y and over with body mass index (BMI) ≥30
kg/m2 or hypertension
Women with a history of GDM
Women with polycystic ovary syndrome (PCOS) who are
obese
Patients on antipsychotic medication
26. Non-modifiable Risk Factors
For Type 2 Diabetes
Age > 40 years
Family history or genetic predisposition
Ethnicity
History of IGT, IFG
Vascular disease
History of gestational diabetes or delivery of macrosomic baby
PCO
Schizophrenia
Hypertension
Dyslipidaemia
27. Modifiable Risk Factors
For Type 2 Diabetes
Abdominal or central obesity
Overweight
Physical inactivity
Dietary factors
28. FPG 100–125 mg/dL
(5.6–6.9 mmol/L): IFG
OR
2-h plasma glucose 140–199 mg/dL (7.8–
11.0 mmol/L): IGT
OR
A1C 5.7–6.4%
Prediabetes*
* For all three tests, risk is continuous, extending below the
lower limit of a range and becoming disproportionately
greater at higher ends of the range.
American Diabetes Association Standards of Medical Care in Diabetes.
Classification and diagnosis of diabetes. Diabetes Care 2016; 39 (Suppl. 1): S13-S22
29.
30. SD4 Where a random plasma glucose level ≥ 100
mg/dl and < 200 mg/dl is detected, a FPG should
be measured or an HbA1c measured.
SD5 Use of HbA1c as a diagnostic test for diabetes
requires that stringent quality assurance tests are
in place and assays are standardized to criteria
aligned to the international reference values, and
there are no conditions present which preclude
its accurate measurement.
SD6 People with screen-detected diabetes should be
offered treatment and care.
SCREENING & DIAGNOSIS
31. Impaired glucose tolerance
Impaired fasting glucose
Intermediate states
High risk of developing diabetes
Increased risk of cardiovascular disease
Prevention strategies must be implemented
to prevent or delay progression
32. Metabolic syndrome
Cluster of risk factors or syndrome
Found in 70 - 80% of people with T2DM
Diagnostic criteria varies globally
Associated with three-fold increase in heart
disease and stroke
Associated with two-fold increase in major
cardiovascular events
(International Diabetes Federation, 2006)
33. Revised ATP III Metabolic Syndrome Oct 2005
*Diagnosis is established when 3 of these risk factors are present.
†Abdominal obesity is more highly correlated with metabolic risk
factors than is BMI.
‡Some men develop metabolic risk factors when circumference is only
marginally increased.
<40 mg/dL
<50 mg/dL or Rx for ↓ HDL
Men
Women
>102 cm (>40 in)
>88 cm (>35 in)
Men
Women
100 mg/dL or Rx for ↑ glucoseFasting glucose
130/85 mm Hg or on HTN
Rx
Blood pressure
HDL-C
150 mg/dL or Rx for ↑ TGTG
Abdominal obesity†
(Waist circumference‡)
Defining LevelRisk Factor
39. Gestational Diabetes
One of the most challenging aspects of diabetes practice
Seemingly easy: Practically difficult
Needs a lot of commitment on part of doctor, patient and
family
Success can be achieved if we try together
40. Definition
Glucose intolerance with onset or first
recognition during pregnancy
Characterized by β-cell function that is
unable to meet the body’s insulin needs
Buchanan, Wiang, Kjos, Watanabe 2007
42. Risk factors for GDM
High risk
Obesity
Age >25ys
Diabetes in 1st degree relative
Previous history of GDM or
glucose intolerance
Previous infant with macrosomia
> 3.5 kg
High risk ethnic group; South
Asian, East Asian, Indigenous
American or Australian, Hispanic
PCOS
Low risk
Age less than 25 years
No previous poor pregnancy
outcomes
No diabetes in 1st degree
relatives
Normal prepregnancy
weight and weight gain
during pregnancy
No history of abnormal
glucose tolerance
Perkins, Dunn, Jagastia, 2007
44. Why diagnose and treat GDM?
No increase in congenital anomalies
Short term risks for the baby
Macrosomia
Neonatal hypoglycemia
Jaundice
Preterm birth
Birth injury
Hypocalcemia/ hypomagnesimia
Respiratory distress syndrome
Long term risks for the baby
Obesity
Type 2 diabetes
45. GDM Diagnosis
2 Approaches for Diagnosing Gestational Diabetes Mellitus (GDM)
AACE- and ADA-
recommended
1-step 75-g 2-hour oral glucose tolerance test (OGTT) 1,2
or
ACOG- recommended 2 steps: a 50-g 1-hour glucose challenge test (GCT) ≥140 mg/dL , followed by
a 100-g 3-hour OGTT (if necessary)3
GDM Diagnostic Criteria for OGTT Testing
75-g 2-hour† 100-g 3-hour*
Fasting plasma glucose
(FPG)
≥92 mg/dL (5.1 mmol/L)2 ≥95 mg/dL (5.3 mmol/L)2
1-hour post-challenge
glucose
≥180 mg/dL (10.0 mmol/L)2 ≥180 mg/dL (10.0 mmol/L)2
2-hour post-challenge
glucose
≥153 mg/dL (8.5 mmol/L2 ≥155 mg/dL (8.6 mmol/L)2
3-hour post-challenge
glucose
≥140 mg/dL (7.8 mmol/L)2
†A positive diagnosis requires that test results satisfy any one of these criteria
*A positive diagnosis requires that ≥2 thresholds are met or exceeded
.1AACE. Endocr Pract. 2011;17(2):1-53.
.2ADA. Diabetes Care. 2013;36(suppl 1):11-66.
.3Committee on Obstetric Practice. ACOG. 2011;504:1-3.
46. Recommendations:
Detection and Diagnosis of GDM (1)
Screen for undiagnosed type 2 diabetes
at the first prenatal visit in those with
risk factors, using standard diagnostic criteria
Screen for GDM at 24–28 weeks of gestation in
pregnant women not previously known to have
diabetes
Screen women with GDM for persistent diabetes
at 6–12 weeks postpartum, using OGTT,
nonpregnancy diagnostic criteria
ADA. III. Detection and Diagnosis of GDM. Diabetes Care 2014;37(suppl 1):S18
47. Lastly we hope that course will achieve
its goals and help you all in getting the
best of the forthcoming conference
UEDA Board
UEDA Diabetes Mini-Course
Aswan Feb. 2016