Hemoglobin A1c trajectories in the first 18 months after diabetes diagnosis in the SWEET diabetes registry.

AIM: A majority of youth with type 1 diabetes do not meet recommended hemoglobin A1c (HbA1c) targets. The SWEET diabetes registry is a multi-national registry of youth with diabetes. We used data from this registry to identify characteristics associated with glycemic control. METHODS: Patients in the SWEET diabetes registry with at least one HbA1c value within 10 days of diagnosis and three follow up measurements in the first 18 months of diagnosis were included (~10% of the SWEET diabetes registry). Locally weighted scatterplot smoothing was used to generate curves of HbA1c. Wilcoxon, Kruskal-Wallis, or χ2-tests were used to calculate differences between groups. RESULTS: The mean HbA1c of youth in the SWEET diabetes registry is highest at diagnosis and lowest between months 4 and 5 post-diabetes diagnosis. HbA1c continues to increase steadily through the first 18 months of diagnosis. There are no differences in HbA1c trajectories based on sex or use of diabetes technology. Youth in North America/Australia/New Zealand had the highest HbA1c throughout the first 18 months of diagnosis. The trajectory of youth from countries with nationalized health insurance was lower than those countries without nationalized health insurance. Youth from countries with the highest gross domestic product (GDP) had the highest HbA1c throughout the first 18 months of diagnosis. CONCLUSIONS: In this subset of patients, the trajectory of youth from countries with nationalized health insurance was lower than those countries without nationalized health insurance. High GDP and high use of technology did not seem to protect from a higher trajectory.

Occurrence of Mycoplasma genitalium in the peritoneal fluid of fertile and infertile women with detailed analysis among infertile women.

OBJECTIVE: To determine the frequency of occurrence of Mycoplasma genitalium infection in the peritoneal fluid of infertile women as compared to fertile women. MATERIALS AND METHODS: We have selected 162 infertile women aged 22-40 years as study subject and 162 women posted for elective caesarean section, were taken as control. Peritoneal fluid of the infertile women and control samples was obtained by suction during diagnostic laparoscopy and M. genitalium infection was diagnosed by PCR method. RESULTS: The genetic material of M. genitalium was detected in the peritoneal fluid of 10 subjects in the infertile group and in 1 from the control group. High prevalence was found in cases with unexplained (13.3%) and primary infertility (6.7%) in comparison to explained (4.5) and secondary infertility (4.5%). Consistent relationship was reported between past obstetric history and presence of M. genitalium infection in infertile subjects. M. genitalium infection was two times more common in women with cervicitis (8.6%) and with blocked fallopian tubes (8.4%). Out of the 101 cases with normal looking uterus, 7 had M. genitalium infection, while 3 out of 61 cases with a congested uterus had infection. The fallopian tubes appeared normal in about 53% cases whereas, inflammation, hydrosalpinx, peritubular adhesions and endometriotic patches were noted in 11.7%, 4.3%, 19.7% and 11.1% of cases respectively. CONCLUSION: Present study shows association between M. genitalium infection and infertility. We suggest routine screening and early treatment of this pathogen because prolonged inflammation of upper genital tract sites may lead to significant reproductive morbidity and infertility.

'Old Is Gold': How Traditional Indian Dietary Practices Can Support Pediatric Diabetes Management.

Nutrition is crucial for maintaining normal growth, development, and glycemic control in young people with diabetes (PwD). Undue restrictions cause nutrient deficiencies as well as poor adherence to meal plans. Widespread availability of low-cost, ultra-processed, and hyperpalatable food is further damaging. Most families struggle to find ways to provide nutritious, yet attractive, food with a low glycemic index (GI). India is one of the oldest continuous civilizations with a rich and diverse cultural and culinary heritage. Traditional dietary practices, including the centuries-old 'Thali' (meaning plate) concept, emphasize combinations (grains, lentils, vegetables, dairy, spices, prebiotics and probiotics, and fats) of local, seasonal, and predominantly plant-based ingredients. These practices ensure that all of the necessary food groups are provided and fit well with current evidence-based recommendations, including the International Society for Pediatric and Adolescent Diabetes (ISPAD) 2018 Guidelines. Techniques for the preparation, cooking, and preservation of food further impact the GI and nutrient availability. These practices benefit nutrient density, diet diversity, and palatability and thus improve adherence to meal plans and glycemic control. This narrative review describes the ancient wisdom, food composition, and culinary practices from across India which are still valuable today. These may be of benefit worldwide to improve glycemic control as well as quality of life, especially in PwD.