Latest news with #T2D
Medscape
6 days ago
- General
- Medscape
NICU Admissions Higher in Pregestational Diabetes
Neonatal intensive care unit (NICU) admission rates were significantly higher among infants born to mothers with pregestational diabetes than among those born to mothers with gestational diabetes (GD). METHODOLOGY: This Irish study compared risks for NICU admission across maternal diabetes subtypes (type 1 diabetes [T1D], type 2 diabetes [T2D], and GD) to refine counselling and neonatal care. Researchers conducted a retrospective analysis of 25,238 births (January 2018 to December 2020) and identified 3905 neonates born ≥ 34 weeks to mothers with diabetes, including those with T1D (n = 67), T2D (n = 60), and GD (n = 3712). Data on gestational age, birth weight, mode of delivery, and maternal age were extracted from the registry. NICU admission details (indications, hypoglycaemia, and respiratory support) and maternal characteristics (body mass index [BMI] > 30 and preeclampsia) were obtained via electronic records. The analysis was performed using quasi-Poisson regression for assessing NICU admission risk ratios (RRs), analysis of variance for comparing gestational age/birth weight, and chi-square tests for comparing categorical variables. The primary outcome was the NICU admission rate; secondary outcomes included respiratory distress, severe hypoglycaemia, and maternal discharge timing. TAKEAWAY: Neonates born to mothers with T1D and T2D had a admission rate of 41.8% (RR, 3.32) and 31.1% (RR, 3.89), respectively, with both significantly higher than that in those born to mothers with GD (12.5%; RR, 0.133; P ≤ .001); the hospital baseline admission rate was 11.5%. ≤ .001); the hospital baseline admission rate was 11.5%. Neonates of mothers with T1D were born earlier (mean, 37 + 1 weeks) than those of mothers with T2D (mean, 38 + 1 weeks; P = .0019) and GD (mean, 39 weeks; P ≤ .001). = .0019) and GD (mean, 39 weeks; ≤ .001). Moreover, they showed significantly higher birth weight centiles than those of mothers with T2D and GD at 25th (T1D vs T2D, P = .0042; T1D vs GD, P ≤ .001), median ( P ≤ .0001 for both), and 75th centiles (T1D vs T2D, P ≤ .0001; T1D vs GD, P = .0009). = .0042; T1D vs GD, ≤ .001), median ( ≤ .0001 for both), and 75th centiles (T1D vs T2D, ≤ .0001; T1D vs GD, = .0009). Respiratory distress dominated T1D admissions (36.7%), while hypoglycaemia was primary in T2D (73.7%). Mothers with pregestational diabetes were more frequently discharged before their infants (T1D, 42.9%; T2D, 31.5%) than those with GD (21.2%). IN PRACTICE: "It is important to counsel mothers on risks and expectations for the newborn period," the authors of the study wrote. "The aim of our study is to describe how the type of maternal diabetes impacts admission to NICU and to provide up-to-date, local data to support healthcare professionals when counselling patients with diabetes in pregnancy," they added. SOURCE: This study was led by Dearbhla Hillick, Rotunda Hospital, Dublin, Ireland. It was published online on May 22, 2025, in the European Journal of Pediatrics . LIMITATIONS: This study was limited by the dataset being unbalanced, with most neonates born to mothers with GD. Neonates of mothers without diabetes requiring NICU admission were not included. Factors such as maternal smoking, raised BMI, or preeclampsia possibly confounded the NICU admission risk. DISCLOSURES: Open access funding was provided by the IReL Consortium. The authors reported having no relevant conflicts of interest.
The Hindu
25-05-2025
- Health
- The Hindu
CBSE's sugar board mandate is a starting point for integrating nutrition education into school curricula, say experts
According to the World Health Organization (WHO), over 390 million children and adolescents aged 5 to 19 years were above a healthy weight globally in 2022, including 160 million facing significant challenges related to excessive weight gain. Studies have shown a strong link between childhood obesity and Type 2 Diabetes (T2D), with many affected children also experiencing weight-related health issues. In India, Type 2 Diabetes is on the rise among Indian children and adolescents, with an estimated incidence rate of 397 per 100,000 in 2021. In response to these rising health concerns, the Central Board of Secondary Education (CBSE), following recommendations from the National Commission for Protection of Child Rights (NCPCR), has directed all affiliated schools to install 'Sugar Boards' by July 15, 2025. The boards aim to visually represent how much sugar is present in commonly consumed snacks and drinks, comparing it with the recommended daily intake. The goal is to increase awareness among children, helping them make healthier food choices by understanding the impact of sugar on their long-term well-being. Schools step up efforts in food education Schools across India are actively responding to this directive. M. A. Anitha, vice principal, Jain International Residential School, Bengaluru, shared that they already follow a system where a dining committee, including students, participates in menu planning. 'We give the complete information in the menu, including calories, and details if the dish contains gluten, nuts, or dairy. This CBSE initiative is not just about removing sugary items; it's about making children aware and letting them choose wisely,' she said. In Chennai, P.S. Senior Secondary School is strategising to align with the CBSE directive while continuing to offer student-friendly options. 'We serve sundal and fruits at the canteen, but children still prefer samosas and potato chips,' said Revathy Parameswaran, principal of the school. 'So we are thinking of designing a combo where they can get the item they crave along with a healthier option.' She also noted the larger lifestyle problem, 'We are living in times where children are not playing outside but staying inside apartments. There's a lack of physical activity, and that's where these boards can make a difference', she said. KRM Public School in Chennai is also extending its proactive food policy. Sivasakti Balan, principal, noted that the school already provides a cyclic menu with high-protein and nutrient-rich meals for kindergarten students and shares the menu with parents at the beginning of the academic year. 'We plan to now expand this model to other classes as well, so there's a common understanding between the school and home when it comes to food,' he said. According to Sandeepa Kumar, principal, Ryan International School, Dombivli -- the move signals a broader need for nutritional literacy in schools, encouraging classroom discussions, cafeteria reforms, and a focus on balanced diets. She emphasised that it underlines the shared responsibility of educators and parents in nurturing long-term, healthy choices in children. Orchid International School in Mumbai is also taking a comprehensive approach to the sugar board mandate, combining awareness, student engagement, and parental involvement. The school has installed sugar boards, displayed healthy eating posters, and planned interactive sessions including student-created boards, skits, and debates. 'Setting up the sugar board is just the first step -- we're involving students, parents, and even doctors in this learning process,' said Naresh Ramamurthy, national academic head of the school. The school will also run dental camps, track students' BMI, monitor canteen sales, and share healthy tiffin suggestions with parents, aiming to build lasting awareness around sugar consumption. Response from parents Parents too are responding to the move with a mix of optimism and practicality. N. Leelanand, parent of a 10-year-old, says his child's school no longer allows fizzy drinks or chips in the canteen. 'At home, we start the day with fruit, and I ensure my child doesn't drink any packaged juices or sodas,' he said. 'Children need to learn early. If they are told now how much sugar is hidden in even regular food, it'll help them make better decisions later.' Bijoya Nair, parent of two teenagers, has tried to replace sugar-rich snacks with healthier home-made options. 'I bake jaggery cupcakes, but they still want the store-bought ones,' she said. She pointed out that if children are more educated at school than by parents, there will be better compliance. Experts call for long-term integrated nutrition literacy Paediatricians are supporting the initiative, highlighting the extent of sugar's impact on children's health. Deepa Easow, senior consultant, paediatrics, MGM healthcare, Chennai, said many parents are unaware of hidden sugar in processed food. 'They don't read labels, and they don't realise ingredients like high fructose corn syrup, maltose, and dextrose are also sugar. Children suffer from fatigue, mood swings, memory problems, and poor concentration. Many kids also show signs of insulin resistance. This is a good step, but not enough.' She added, 'We need sugar education in the syllabus. Children should learn how to read labels and understand food. They must know that fruit juice is not the same as fruit. That's where change begins.' Tejasvi Sheshadri, paediatrician and paediatric endocrinologist, paediatric diabetes specialist, Rainbow Children's Hospital, Hebbal, Bengaluru, said she has seen a spike in obesity and early insulin resistance among children post-Covid. 'There's darkening of the neck, increased weight, and early signs of metabolic disorders. Physical activity is still low, and diets are still sugar-heavy. This CBSE mandate could be a turning point', she said. Similarly, nutritionists also echo the call for broader, more integrated strategies. Meenakshi Bajaj, a dietician with the Tamil Nadu Government Multi Super Specialty Hospital, welcomed the move but emphasised that the change must go beyond school walls. 'Children can always buy junk from outside the school. What we need is structured nutrition education. We should have a subject on food and eating, with lessons tailored to each age group,' she said. She also urges for fun, child-friendly approaches, 'We could have a sugar board game -- like snake and ladder -- where junk food sends you down and vegetables lift you up. Each step could have fun facts about nutrients. Let's make health aspirational,' she said. According to the experts, the Sugar Board initiative is not just about visual charts or banning soft drinks -- it's about building an ecosystem of awareness that includes educators, parents, medical experts, and, most importantly, children themselves. If sustained with creativity, consistency, and community support, this move could fundamentally reshape how Indian children engage with food.
The Hindu
25-05-2025
- Health
- The Hindu
CBSE's sugar board mandate is starting point for integrating nutrition education into school curriculums: experts
According to the World Health Organization (WHO), over 390 million children and adolescents aged 5 to 19 years were above a healthy weight globally in 2022, including 160 million facing significant challenges related to excessive weight gain. Studies have shown a strong link between childhood obesity and Type 2 Diabetes (T2D), with many affected children also experiencing weight-related health issues. In India, Type 2 Diabetes is on the rise among Indian children and adolescents, with an estimated incidence rate of 397 per 100,000 in 2021. In response to these rising health concerns, the Central Board of Secondary Education (CBSE), following recommendations from the National Commission for Protection of Child Rights (NCPCR), has directed all affiliated schools to install 'Sugar Boards' by July 15, 2025. The boards aim to visually represent how much sugar is present in commonly consumed snacks and drinks, comparing it with the recommended daily intake. The goal is to increase awareness among children, helping them make healthier food choices by understanding the impact of sugar on their long-term well-being. Schools step up efforts in food education Schools across India are actively responding to this directive. M. A. Anitha, vice principal, Jain International Residential School, Bengaluru, shared that they already follow a system where a dining committee, including students, participates in menu planning. 'We give the complete information in the menu, including calories, and details if the dish contains gluten, nuts, or dairy. This CBSE initiative is not just about removing sugary items; it's about making children aware and letting them choose wisely,' she said. In Chennai, P.S. Senior Secondary School is strategising to align with the CBSE directive while continuing to offer student-friendly options. 'We serve sundal and fruits at the canteen, but children still prefer samosas and potato chips,' said Revathy Parameswaran, principal of the school. 'So we are thinking of designing a combo where they can get the item they crave along with a healthier option.' She also noted the larger lifestyle problem, 'We are living in times where children are not playing outside but staying inside apartments. There's a lack of physical activity, and that's where these boards can make a difference', she said. KRM Public School in Chennai is also extending its proactive food policy. Sivasakti Balan, principal, noted that the school already provides a cyclic menu with high-protein and nutrient-rich meals for kindergarten students and shares the menu with parents at the beginning of the academic year. 'We plan to now expand this model to other classes as well, so there's a common understanding between the school and home when it comes to food,' he said. According to Sandeepa Kumar, principal, Ryan International School, Dombivli -- the move signals a broader need for nutritional literacy in schools, encouraging classroom discussions, cafeteria reforms, and a focus on balanced diets. She emphasised that it underlines the shared responsibility of educators and parents in nurturing long-term, healthy choices in children. Orchid International School in Mumbai is also taking a comprehensive approach to the sugar board mandate, combining awareness, student engagement, and parental involvement. The school has installed sugar boards, displayed healthy eating posters, and planned interactive sessions including student-created boards, skits, and debates. 'Setting up the sugar board is just the first step -- we're involving students, parents, and even doctors in this learning process,' said Naresh Ramamurthy, national academic head of the school. The school will also run dental camps, track students' BMI, monitor canteen sales, and share healthy tiffin suggestions with parents, aiming to build lasting awareness around sugar consumption. Response from parents Parents too are responding to the move with a mix of optimism and practicality. N. Leelanand, parent of a 10-year-old, says his child's school no longer allows fizzy drinks or chips in the canteen. 'At home, we start the day with fruit, and I ensure my child doesn't drink any packaged juices or sodas,' he said. 'Children need to learn early. If they are told now how much sugar is hidden in even regular food, it'll help them make better decisions later.' Bijoya Nair, parent of two teenagers, has tried to replace sugar-rich snacks with healthier home-made options. 'I bake jaggery cupcakes, but they still want the store-bought ones,' she said. She pointed out that if children are more educated at school than by parents, there will be better compliance. Experts call for long-term integrated nutrition literacy Paediatricians are supporting the initiative, highlighting the extent of sugar's impact on children's health. Deepa Easow, senior consultant, paediatrics, MGM healthcare, Chennai, said many parents are unaware of hidden sugar in processed food. 'They don't read labels, and they don't realise ingredients like high fructose corn syrup, maltose, and dextrose are also sugar. Children suffer from fatigue, mood swings, memory problems, and poor concentration. Many kids also show signs of insulin resistance. This is a good step, but not enough.' She added, 'We need sugar education in the syllabus. Children should learn how to read labels and understand food. They must know that fruit juice is not the same as fruit. That's where change begins.' Tejasvi Sheshadri, paediatrician and paediatric endocrinologist, paediatric diabetes specialist, Rainbow Children's Hospital, Hebbal, Bengaluru, said she has seen a spike in obesity and early insulin resistance among children post-Covid. 'There's darkening of the neck, increased weight, and early signs of metabolic disorders. Physical activity is still low, and diets are still sugar-heavy. This CBSE mandate could be a turning point', she said. Similarly, nutritionists also echo the call for broader, more integrated strategies. Meenakshi Bajaj, a dietician with the Tamil Nadu Government Multi Super Specialty Hospital, welcomed the move but emphasised that the change must go beyond school walls. 'Children can always buy junk from outside the school. What we need is structured nutrition education. We should have a subject on food and eating, with lessons tailored to each age group,' she said. She also urges for fun, child-friendly approaches, 'We could have a sugar board game -- like snake and ladder -- where junk food sends you down and vegetables lift you up. Each step could have fun facts about nutrients. Let's make health aspirational,' she said. According to the experts, the Sugar Board initiative is not just about visual charts or banning soft drinks -- it's about building an ecosystem of awareness that includes educators, parents, medical experts, and, most importantly, children themselves. If sustained with creativity, consistency, and community support, this move could fundamentally reshape how Indian children engage with food.
Medscape
23-05-2025
- Health
- Medscape
GLP-1s Lower Pancreatitis Complications, Mortality in T2D
Patients with type 2 diabetes (T2D) who received glucagon-like peptide 1 (GLP-1) receptor agonists had a significantly lower risk of developing local or systemic complications — even if they developed acute pancreatitis — and showed more than a 50% reduction in risk for all-cause mortality than those who did not receive these medications. METHODOLOGY: Patients with T2D may experience heightened local and systemic complications from acute pancreatitis, often requiring prolonged and intensive care; however, data on outcomes among those treated with GLP-1s remain limited, highlighting a significant knowledge gap. Researchers conducted a retrospective cohort study using population-based data to evaluate the influence of GLP-1s on acute pancreatitis risk and associated outcomes in patients with T2D identified between January 2015 and October 2023. The analysis included 20,459 patients with T2D who received GLP-1s including semaglutide, liraglutide, dulaglutide, or tirzepatide (mean age, 58.1 years; 49.85% women); the patients were propensity score–matched with those not receiving these medications. The primary outcome was the development of acute pancreatitis and the subsequent clinical trajectory of affected patients, including the need for parenteral nutrition, the occurrence of systemic complications, and the incidence of local pancreatic complications. The secondary outcome was all-cause mortality. TAKEAWAY: Patients who received GLP-1s tended to have a lower risk for acute pancreatitis than those who did not, although this finding was not statistically significant. However, among patients with acute pancreatitis, those who received GLP-1s had a significantly lower risk of developing complicated pancreatitis (hazard ratio [HR], 0.32; P = .05) and a reduced need for parenteral nutrition (HR, 0.28; P = .01) than those who did not receive these GLP-1s. = .05) and a reduced need for parenteral nutrition (HR, 0.28; = .01) than those who did not receive these GLP-1s. The risks for systemic complications, including sepsis, acute kidney injury, shock, and the need for mechanical ventilation, were significantly lower in patients who received GLP-1s than those who did not ( P < .001 for all). < .001 for all). The risk for all-cause mortality was 55% lower in those who received GLP-1s than in those who did not (HR, 0.45; P < .001). IN PRACTICE: '[The study] results provide a compelling rationale for reconsidering GLP-1s as not only antidiabetic agents but also as key components in the management of diabetes-related complications, including AP [acute pancreatitis],' the study authors wrote. SOURCE: This study was led by Luis M. Nieto, MD, Division of Digestive Diseases, Emory School of Medicine in Atlanta. It was published online in The American Journal of Gastroenterology . LIMITATIONS: This study did not discuss any limitations. DISCLOSURES: This study received no specific funding. The authors reported having no conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. Credit Lead image: Tashatuvango/Dreamstime Medscape Medical News © 2025 WebMD, LLC Cite this: Edited by Archita Rai. GLP-1s Lower Pancreatitis Complications, Mortality in T2D - Medscape - May 23, 2025.
Medscape
22-05-2025
- Health
- Medscape
Urine Metabolites Could Forecast Renal Outcomes in T2D
Increased levels of urine metabolites choline and dimethylglycine were independently associated with an increased risk for renal events and all-cause mortality in patients with type 2 diabetes (T2D), with evidence suggesting that tubular stress partly mediated the link between disrupted choline metabolism and the gradual decline in kidney function in this population. METHODOLOGY: Although elevated plasma choline levels are linked to a greater risk for kidney disease progression in patients with T2D, the relationship between choline metabolism in the kidneys and the progression of kidney disease is not well understood. Researchers analyzed data of 1894 patients with T2D (mean age, 57.4 years; 51.1% men) from a regional hospital and a primary care facility in Singapore to study the role of urine metabolites of the choline oxidation pathway in the progression of chronic kidney disease (CKD). Urine metabolites (choline, betaine, dimethylglycine, and sarcosine) were quantified or semiquantified using liquid chromatography-mass spectrometry. Variables such as heart conditions, blood pressure, tubulopathy biomarkers, and estimated glomerular filtration rate (eGFR) were either self-reported or measured, with patients being followed-up using electronic medical records and in-person research visits. The primary outcome was a composite of incident end-stage kidney disease (defined as having a sustained eGFR < 15 mL/min/1.73 m2, undergoing maintenance dialysis, or death from renal causes) or the doubling of serum creatinine levels. TAKEAWAY: Overall, 263 participants experienced renal events over a median follow-up of 9.2 years. Those who experienced renal events had higher baseline levels of urine choline (median, 32.1 vs 16.9 µM) and dimethylglycine (median, 1.25 vs 0.74 units) than those who did not. Each SD increase in levels of urine choline (adjusted hazard ratio [aHR], 1.33) and dimethylglycine (aHR, 1.30) was associated with an increased risk for the composite renal outcome ( P < .001 for both). < .001 for both). Researchers postulated that tubular stress may partly mediate the link between urine choline, dimethylglycine, and the risk for adverse renal outcome. After adjusting for clinical risk factors, each SD increase in levels of urine choline and dimethylglycine was associated with a 1.2-fold and 1.17-fold increase in the risk for all-cause death, respectively ( P < .05 for both). IN PRACTICE: 'High levels of urine choline and dimethylglycine in the choline oxidation pathway were strongly associated with a high risk for CKD progression independent of traditional risk factors in individuals with type 2 diabetes. Dysregulation of choline metabolism in the kidney may be involved in pathogenesis of tubulopathy and plays a role in progressive loss of kidney disease,' the authors wrote. SOURCE: This study was led by Jian-Jun Liu, Clinical Research Unit, Khoo Teck Puat Hospital (KTPH) in Singapore. It was published online on May 13, 2025, in Journal of Clinical Endocrinology & Metabolism . LIMITATIONS: It could not be inferred whether urine metabolites caused kidney disease progression. Residual confounding could not be ruled out due to observational nature of this study. Some of the urine metabolites were semiquantified with relatively high technical differences. DISCLOSURES: This study received grants from KTPH STAR and Singapore National Medical Research Council. The authors reported having no relevant conflicts of interest. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication. Medscape Medical News © 2025 WebMD, LLC Cite this: Urine Metabolites Could Forecast Renal Outcomes in T2D - Medscape - May 22, 2025.
