The Fifth Libyan Diabetes and Endocrinology Conference (LDEC2007) was held over the first three days of May this year. Tripoli's spring weather was at its best and the venue, Teachers’ Union Hall on “Treeg Ashatt”, gave the meeting a very cozy ambience of a family gathering rather than an official academic conference.
Conference Background
LDEC2007 is the fifth in a series of professional meetings conducted by those interested and practising in the fields of diabetes and endocrinology. Indeed the first three conferences ranged in duration from half a day to one day. They involved an increasing number of faculty and attracted more delegates. However, the fourth and fifth meetings expanded significantly, spanning three days and involving larger numbers of doctors practising at home (almost all diabetes and endocrine physicians in Tripoli and Benghazi) and Libyan endocrinologists practising abroad (10 attended LDEC2006 and 15 attended LDEC2007). The previous four conferences were held officially under the auspices of the Libyan Board for Medical Specialities (LBM) while LDEC2007 was jointly organized by LBM and the Libyan Society for Diabetes and Endocrinology (LSDE), being the latter's inaugural meeting.
Target Delegates And Conference Agenda
As the national event for the specialty, the organizing team had a difficult task to meet. Eventually all agreed that the target delegates were broad covering consultants and specialists in diabetes and endocrinology, other branches of general internal medicine as well as primary health care providers practising in hospitals and polyclinics. Therefore, the contents were tiered to provide a scientifically sound and clinically relevant review and update of the important topics in diabetes and endocrinology. In addition, as in LDEC2006, a special workshop for nurses and diabetes educators was organized on the second day. A scientific committee, an organizing committee and a national advisory board were formed. Because of the geographical locations of the organizing team members, all methods of communication were utilized; personal, phone, SMS and E-mails. Abstracts from all invited speakers and the accepted free communications were collated together.
Scientific Program
The program layout followed the international style of scientific meetings of plenary sessions, state of the art lectures and medal/memorial lectures together with symposia, workshops and interactive sessions. A guest speaker who just rose to the consultant grade delivered the first LSDE annual lecture for this year. The organizing committee proposed that this particular lecture is reserved for the young and aspiring clinicians and medical scientists within five years of their senior appointments. The memorial lecture of this year was dedicated to the late Dr Makkram Addawi. Dr Addawi, an ENT surgeon and a former clinical vice dean in Tripoli, taught many of the Society's members including the chosen lecturer himself. A satellite symposium on insulin therapy was organized by Sanofi-Aventis and Julphar on the eve of the conference.
The first day began with welcoming remarks from Dr. Beshyah and Dr. Hajjaji. The programme was then kick started by Dr. Lakhdar's “Key Note Address” on “Challenges of diabetes care in the Arab world”. He gave a review of the epidemiological data confirming the increasing size of the problem and emphasized the need for national diabetes programmes to address diabetes prevention in high-risk groups and detection of undiagnosed patients. Professor M. Rashed, The Secretary of the General Peoples' Committee for Health and Environment and Professor M. Zaidi, The Secretary General of the Libyan Board for Medical Specialties opened the conference officially. The opening ceremony was attended by the Ambassador of the United Kingdom and Charge D'Affaires of the United Arab Emirates. The first symposium was on “Reducing the Cardiovascular risk in Diabetes”. Dr. H. El-Sheirf gave an update on management of hypertension in diabetes with a comprehensive overview of the trials and guidelines outlining the goals and indications of various drugs. Dr. A. Elhouni followed on by a discussion on the biochemical basis of diabetic dyslipidaemia and its management. Dr. I. Treki gave an overview of diabetes and stroke and Dr. I. Hajjaji finished the symposium by a presentation on hyperbaric oxygen and its potential uses in diabetes care. Dr. M. Benbarka delivered the first “state of the art” lecture on insulin pump therapy: the evidence base and clinical practice. He started by an historic background on the idea of an insulin pump and its evolution to current day technology. He argued his case in favour of the insulin supported by trial data from DCCT and the international guidelines of good practice in diabetes care. The afternoon session started with the “LSDE Inaugural Lecture” delivered by Dr. H. Ziglam on metabolic complications of HIV infection and retroviral drugs. This was followed by interactive small group discussions where delegates broke into five small groups, providing the open exchange of ideas and questions relevant to clinical practice and covering: diabetes in pregnancy (M. Eledrisi), thyroid eye disease (N. Rhym), hyperprolactinaemia and pregnancy (H. Kallousa), hyponatraemia (F. Mohamed) and clinical cases in pediatric endocrinology (A. Deeb, A. Shamekh and F. Ben Rajab). After a refreshment break, the evening session began with a workshop on modern management of type 2 diabetes presented by Professor A. Swalem discussing the old and newer oral hypoglycemic agents and Dr. M. Benbarka talking about practical insulin therapy. The first day was brought to a nice close by a long standing ovation honouring Professor Emeritus Othman Kadiki who delivered The Ibnosina Medal Lecture on “Diabetes in Benghazi: Achievements and challenges”.
The second morning started with a comprehensive plenary lecture on “Diagnosis and medical treatment of pituitary tumors” by Professor S. Gerryo and finished by the state of the art lecture on “Diabetic eye disease: best practice in screening and management” by Dr. S. Abugreen, sandwiching a clinical symposium on “obesity in adults”. Dr Beshyah discussed the global and regional size of the obesity problem and medical complications of obesity in adults. Therapeutic life style modification for obesity were passionately presented by Dr. S. Bosseri, and the effective use of anti-obesity drugs with special reference to diabetes argued by Dr. A. Salhin. Finally Dr. R. Kerwat made the role of surgery for the severely morbid obesity simple for physicians. The afternoon session started by the “Clinical Endocrinology and Diabetes”. Four original abstracts were presented: Audit of the Management of Type 1 Diabetes in Tripoli Children's Hospital, Clinical and Biochemical Characteristics of Polycystic Ovary Syndrome in Benghazi, Libya, Prescribing Patterns of Antihypertensive Agents in Hospitalized Diabetic Patients in Tripoli, Libya and Thyroid Cancer in Northeastern Libya. The interactive small group discussions for the second day focused on: Care for the Diabetic Foot (S. Bosseri and A. El-Houni), Recent Trials in Diabetes of Relevance to Clinical Practice (I. Treki and A. Lakhdar), Investigating Endocrine Hypertension (F. Mohamed) and Primary Hyperparathyroidism: To Treat Or To Follow (T. Fiad and D. Oheba). The workshop “Diabetes in Crises” gave the opportunity to gain more understanding of management of diabetes in the hospitalized patient particularly in the peri-operative period (A. Salhin), management of diabetes in the intensive care settings (A. Lakhdar), glycometabolic state at admission: important risk marker of mortality in patients with diabetes mellitus and acute myocardial infarction (K. Abouglila) and the role of newer anti microbial agents in skin and soft tissue infections in diabetes (H. Ziglam). Al-Fitouri Medal Lecture 2007 named after Mohamed Al-Fitouri, the first Libyan medical graduate on record, was the last article of business for the day and was masterly delivered by Tarek Fiad on the subject of “Diabetic neuropathy: timely recognition and effective management”
The third morning had two plenary lectures on the controversial issue of “subclinical thyroid disease” by Professor A. Swalem and “The standards of medical care in diabetes 2007” by M. Eledrisi. In between these two lectures, the delegates were served a blend of diabetes and endocrinology in young people. The subjects covered the epidemiology of diabetes in western parts of Libya by Professor S. Abusrewil. Type 2 diabetes in childhood was discussed by Dr. E. Hadeed and modern management of type 1 diabetes in children was discussed Dr. A. Shamekh. Dr. A. Deeb gave an overview of the molecular basis and clinical implications of gender differentiation disorders followed by a presentation on surgical correction of intersex cases in Tripoli medical centre by Mr. B. Gharmool. The local experience with Triple A syndrome was presented by Dr. A. Alghadafi. The afternoon session included five parallel interactive group discussions on, Interpretation of “Funny” Thyroid Functions (M. Benbarka), Management of Polycystic Ovary Disease (A. Salhin), iInitiating and Advancing Insulin Treatment (M. Eledrisi), Infection in Diabetes (H. Ziglam) and Hypoglycemia (T. Fiad). The closing lecture for LDEC2007 was Dr. Makkram Addawi Memorial Lecture delivered by F. Mohamed on “Evidence-based management of thyroid nodules”.
The committee gave priority to the original abstracts describing disease processes in our country, and rated them blindly. Six abstracts were presented as oral communications and eight posters were displayed throughout the conference period. The poster presentations included: Neonatal Hypercalcaemia, Post Kidney Transplant Diabetes Mellitus Among Follow up Patients in Benghazi, Characteristics and Outcome of Diabetic Patients Admitted With Acute Myocardial Infarction In Benghazi, Infant of The Diabetic Mother, Accuracy of Fine-needle Aspiration Biopsy of Thyroid Nodules Combined With an Evaluation of Clinical and Ultrasonographic Characteristics, Pituitary and Other Intrasellar Tumors In Tripoli and in Benghazi and The Hospitalization Pattern of Patients With Diabetes. At the closing ceremony, two pioneering endocrinologists awarded the LSDE's prizes for the best oral and best poster presentations to Dr. Ben Rajab and Dr. Shermaddo respectively. The program was nationally accredited by the Libyan Board for Medical Specialities and internationally by the Royal College of Physicians of London for a maximum of 18 CPD/CME Credits.
Social Programme
Although there was no formal social programme as most delegates were homegrown, and very familiar with the attractions of Tripoli, there was plenty of time for social interaction between the delegates from different localities and age groups. Many have not seen each other for a long time (longest was Benbarka and Gerryo nearly 30 years!). Refreshment breaks and traditional Libyan meals were served for lunch at the lecture hall. The well-attended Conference Dinner gave a further opportunity for informal exchange of thoughts and allowed people to meet at leisure and interact freely. It was truly the meeting of the generations bringing together doctors who graduated over nearly a 50 year period between 1958 to 2007. Many of the younger colleagues appreciated the opportunity of meeting the leading figures in the specialty at a personal level.
The feedback and comments received were very positive. Many people were proud that the programme was a big success from all aspects.