Carbohydrate Intolerance Research Articles

Congenital enteropathies in children: An algorithm for differential diagnosis and therapeutic management. Case report

Infant diarrhea may be caused by infectious, allergic, or surgical diseases. A distinct group comprises congenital enteropathies, a heterogeneous group of genetically determined diseases, including defects in the absorption and transport of nutrients and electrolytes, impaired differentiation of enterocytes and enteroendocrine cells, and defects in the modulation of the intestinal immune response. The final diagnosis of enteropathies is based on the results of molecular genetic tests; however, a detailed assessment of clinical and medical history data and the results of laboratory and instrumental studies enables quick diagnostic search direction and choice of the correct therapeutic tactics. The article considers the algorithm for the differential diagnosis of congenital diarrhea, presents a clinical case of congenital osmotic diarrhea due to disaccharidase insufficiency, and considers the difficulties of the diagnostic search and approaches to diet therapy. The prospective of using a fructose-based formula, Galactomin-19, in the diet therapy of glucose-galactose malabsorption, is presented.

Food-Intolerance Genetic Testing: A Useful Tool for the Dietary Management of Chronic Gastrointestinal Disorders.

The rise in food intolerances and celiac disease, along with advanced diagnostic techniques, has prompted health professionals to seek effective and economical testing methods. This study evaluates combining genetic tests with routine carbohydrate-absorption breath tests to classify patients with chronic gastrointestinal disorders into therapeutic groups, enhancing dietary management and improving gut health and quality of life. Forty-nine patients with suspected carbohydrate intolerance underwent genetic testing for lactase non-persistence, hereditary fructose intolerance, and celiac disease risk. Simultaneously, breath tests assessed lactose and fructose absorption. The lactase non-persistence genotype appeared in 36.7% of cases, with one hereditary fructose-intolerance case in a heterozygous condition. Celiac disease risk markers (HLA-DQ2/8 haplotypes) were found in 49.0% of the population. Secondary lactose and/or fructose malabsorption was present in 67.3% of patients, with 66.1% of lactase non-persistence individuals showing secondary lactose malabsorption. Fructose malabsorption was prevalent in 45.8% of patients at risk for celiac disease. Two main treatment groups were defined based on genetic results, indicating primary and irreversible gastrointestinal disorder causes, followed by a sub-classification using breath test results. Genetic testing is a valuable tool for designing dietary management plans, avoiding unnecessary diet restrictions, and reducing recovery times.

Hypoglycaemic activity of the anthocyanin enriched fraction of Lycium ruthenicum Murr. Fruits and its ingredient identification via UPLC–triple-TOF-MS/MS

Lycium ruthenicum Murr. is mainly distributed in the northwest region of China and its berries are rich in anthocyanin. This study evaluated the hypoglycaemic activity of the anthocyanin-enriched fraction (AEF) of L. ruthenicum Murr. on α-glucosidase in vivo and in vitro. Overall, 10 anthocyanins were identified via UPLC–Triple-TOF-MS/MS. The AEF exhibited strong inhibitory activity against α-glucosidase, with an IC50 value of 4.468 mg/mL. It behaved as a reversible, mixed-type inhibitor. Molecular docking and dynamic results indicated that the compounds in AEF interacted with enzymes primarily through van der Waals and hydrogen bond and the complex system was stable. The postprandial blood glucose and area under the curve of diabetic mice was significantly decreased by AEF in the carbohydrate tolerance experiments. The results indicate that the AEF from L. ruthenicum Murr. berries could be as a promising food supplement for managing blood sugar levels in patients with diabetes mellitus.

Itch prevalence analysis and its characteristics among acne patients

Introduction. Acne is a multifactorial chronic inflammatory disease of the pilosebaceous follicle, which manifests itself as open and closed comedones, papules, pustules and nodules.Purpose of the study. Studying of itch prevalence among patients with acne, as well as assessing its impact on their quality of life and psychoemotional status.Materials and methods. Under observation were 249 patients diagnosed with acne aged from 12 to 50 years, of which 143 women (57.4%), 106 men (42.6%). Patients were diagnosed based on complaints, anamnesis and clinical picture of the disease. To assess the impact of itching on the quality of life, the Acne Psychological and Social Effect Scale (APSEA), the Dermatological Life Quality Index (DLQI), the Cardiff Social Disadaptation Index (CADI), the Rosenberg self-esteem scale, and a self-developed questionnaire were used to assess the impact of itching on the quality of life. Questionnaire, YOUR itch.Results. To solve these problems, based on the criteria for inclusion, non-inclusion and exclusion, two clinical comparison groups were formed, comparable in terms of main clinical diagnostic indicators. The first group consisted of patients with itching due to acne (64 people, 26% of subjects), the second group consisted of patients with no itching (185 people, 74% of subjects). According to the results of the study, a statistically significant relationship between the presence of itching in acne and age, gender, the presence of obesity, impaired carbohydrate tolerance, iron deficiency anemia, hyperprolactinemia was revealed, various characteristics of itching in the subjects were described, and a close correlation of the indicators of the indices used was revealed.Conclusions. Studying the prevalence of itching in acne is a relevant area and allows us to expand our understanding of the role of subjective sensations in the development of acne and further evaluate the impact of this dermatosis on the quality of life of patients.

Epidemiology of Gestational Diabetes Mellitus: Newer Evidence to curtail

Gestational diabetes mellitus (GDM) is a state metabolic disorder caused by carbohydrate intolerance during pregnancy for the first time. This disease is very important as it affects the mother and fetus. It is said that GDM disrupts the pregnancy process and causes many diseases, such as recurrent miscarriage, congenital anomalies, preeclampsia, stillbirth, macrosomia, preterm birth, and emergency delivery after pregnancy, pregnancy, and delivery. It also causes long-term complications by inducing type 2 diabetes mellitus in mothers and children. GDM is generally considered a lifestyle disorder, and therefore, its burden varies by race, geographic boundaries, genetics, and reproductive risk. Consequently, it is necessary to investigate the prevalence and risk of GDM to evaluate prevention strategies. Ist Trimester early management of Dysglycemia with Medical Nutrition Treatment (MNT) and Metformin is promising. It might be advocated in the future for curtailing the epidemic of GDM and Type 2 Diabetes. Recently, the TOBOGM study and our ongoing trial with early dysglycemia in 8-10 weeks of gestation resulted in better maternal-fetal outcomes and reduced GDM conversion during pregnancy. This publication is important as the final results of our trial will be published soon

Optimized extraction, enrichment, identification and hypoglycemic effects of triterpenoid acids from Hippophae rhamnoides L pomace

The Hippophae rhamnoides L. pomace was generated in the production process for juice, wine of food industry. To expand the application of pomace, the extraction process optimization, enrichment and identification of triterpene acids were performed in this study. The extraction yield was 14.87% under optimal ultrasound-assisted extraction techniques performed via response surface methodology. The extract was subsequently purified to obtain the triterpenoid acid enrichment fraction (TPF) with the content of 75.23% ± 1.45%. 13 triterpenoid acids were identified via UPLC-Triple-TOF MS/MS and further semi-quantified through comparison with triterpenoid acid standards. TPF exhibited a strong inhibitory effect on α-glucosidase with IC50 value of 5.027 ± 0.375 μg/mL, as determined via enzyme inhibition experiment and molecular docking. Additionally, the TPF significantly reduced postprandial glucose levels, as revealed via carbohydrate tolerance tests, as well as ameliorate serum lipid profiles. Therefore, pomace may be a promising resource of functional food components with therapeutic and commercial values.

Comparative evaluation of the antihyperglycemic effects of three extracts of sea mustard (Undaria pinnatifida): In vitro and in vivo studies

Undaria pinnatifida (UP) contains multiple bioactive substances, such as polyphenols, polysaccharides, and amino acids, which are associated with various biological properties. This study aimed to evaluate the antihyperglycemic effects of three extracts obtained from UP. UP was extracted under three different conditions: a low-temperature water extract at 50 °C (UPLW), a high-temperature water extract at 90 °C (UPHW), and a 70 % ethanol extract (UPE). Nontargeted chemical profiling using high-performance liquid chromatography-triple/time-of-flight mass spectrometry (HPLC−Triple TOF−MS/MS) was conducted on the three UP extracts. Subsequently, α-glucosidase inhibitory (AGI) activity, glucose uptake, and the mRNA expression of sodium/glucose cotransporter 1 (SGLT1) and glucose transporter 2 (GLUT2) were evaluated in Caco-2 cell monolayers. Furthermore, an oral carbohydrate tolerance test was performed on C57BL/6 mice. The mice were orally administered UP at 300 mg/kg body weight (B.W.), and the blood glucose level and area under the curve (AUC) were measured. Compared with glucose, UPLW, UPHW and UPE significantly inhibited both glucose uptake and the mRNA expression of SGLT1 and GLUT2 in Caco-2 cell monolayers. After glucose, maltose, and sucrose loading, the blood glucose levels and AUC of the UPLW group were significantly lower than those of the control group. These findings suggest that UPLW has antihyperglycemic effects by regulating glucose uptake through glucose transporters and can be expected to alleviate postprandial hyperglycemia. Therefore, UPLW may have potential as a functional food ingredient for alleviating postprandial hyperglycemia.

Physical activity levels of pregnant women at the time of diagnosis with gestational diabetes attending a tertiary care hospital in Lucknow City, Uttar Pradesh

: Gestational Diabetes Mellitus (GDM) is one of the pregnancy complications characterized by carbohydrate intolerance that develops or is discovered during pregnancy. Physical inactivity and excessive gestational weight gain have been identified as independent risk factors for maternal obesity and pregnancy-related disorders, such as gestational diabetes. Awareness of the significance of physical activity for bodily and psychological health is vitally essential. The woman and her family members need to be swayed to change with time and let go of their myths and false cultural perceptions that exercise can harm the baby. : To determine the physical activity pattern of pregnant women at the time of diagnosis with GDM. : 188 pregnant women diagnosed with gestational diabetes mellitus was selected for the study. Pregnancy Physical Activity Questionnaire was used to calculate the duration; frequency, intensity, and type of physical activity during current gestational period. An average weekly energy expenditure in Metabolic Equivalent of Task (MET-h-week) was calculated. Demographic data including age, socioeconomic status, parity, literacy and working status were collected. Data was analysed on 188 pregnant women diagnosed with GDM. The physical activity of moderate intensity was less performed by the pregnant women. None of the pregnant women were involved in vigorous type of physical activity. Only light intensity activities were performed by the study participants. The study concluded light intensity activity was commonly carried by pregnant women thus a low level of physical activity was observed during the pregnancy.

Comparative proteomic analysis of pathological characterization of adipose tissue remodeling induced by high-fat diet and high-carbohydrate diet in grass carp (Ctenopharyngodon idellus)

Our previous research found that excessive accumulation of adipose tissue is an important factor that reduces fish tolerance and utilization of high-energy feeds and limits the development of high-energy feeds in the aquaculture industry. However, the pathological characteristics and molecular mechanisms of fish adipose tissue remodeling caused by high-energy diet were still unclear. In this study, using histopathological observation, we found that restricted adipocyte hyperplasia, adipocyte hypertrophy, inflammation, and fibrosis are the main characteristics of pathological remodeling of fish adipose tissue induced by high-fat diet (HFD) and high-carbohydrate diet (HCD). Besides, this study further analyzed the molecular mechanisms and key marker proteins invovled in pathological remodeling of adipose tissue induced by HFD and HCD through comparative proteomics. The results found: (1) Inhibition of the differentiation of preadipocytes may be the main pathway through which both HCD and HFD inhibited adipocyte hyperplasia in grass carp; (2) Although both HFD and HCD induce adipocyte hypertrophy by increasing the de novo lipogenesis (DNL) pathway and promoting triglycerides (TG) synthesis. But the difference is that HFD increases fatty acid transport, while HCD increases glycolysis; (3) The inhibitory effect of HCD on glucose transporter type 4 (Glut4) may be an important cause of carbohydrate intolerance in fish; (4) Both HFD and HCD increase lactate production by promoting the expression of lactate dehydrogenase (Ldh), which may be the molecular mechanism of high-energy diet-induced adipose tissue hypoxia; (5) Interleukin-8 (Il-8) can be used as a pro-inflammatory marker for identifying HFD and HCD induced adipose tissue inflammation. This study aims to incestigate the reasons why HFD and HCD have negative effects on fish from the perspective of pathological remodeling of adipose tissue, and provide new underlying regulatory targets for improving the tolerance and utilization of HCD or HFD in farmed fish.

Determination of the Contributing Factors and HbA1c Cutoff Leading to Glucose Tolerance Abnormalities Following Gestational Diabetes.

The prevalence of gestational diabetes mellitus (GDM) has been steadily increasing over the past years. It is a major risk factor for glucose intolerance and type 2 DM (T2DM). The American Diabetes Association recommends that women whose pregnancy was complicated by GDM be screened for persistent glucose abnormalities at six to 12 weeks postpartum with either a fasting plasma glucose test alone or with a fasting 75-g, two-hour oral glucose tolerance test. This study aimed to identify the main predictive factors of glucose tolerance disorders in early postpartum women with a recent history of GDM. In this retrospective descriptive study, we identified 400 women who met the eligibility criteria for the study. The mean age was 34.54 ± 5.51 years. A total of 70% had a family history of DM, 16% had a personal history of GDM, and 23% had fetal macrosomia in previous pregnancies. The overall incidence of postpartum carbohydrate tolerance disorders was 36.4%, including 12% prediabetes and 24.4% DM. The prevalence of prediabetes and T2DM after delivery was higher with older maternal age, multigravidity, a higher BMI, a history of GDM, and fetal macrosomia in previous pregnancies. Furthermore, the persistence of this impaired glucose tolerance in postpartum was associated with a higher term of diagnosis, a higher glycated hemoglobin (HbA1c) percentage (the discriminant cutoff value with the best sensitivity/specificity ratio was 5.25%), the use of insulin therapy, cesarean section delivery, and fetal macrosomia. After adjusting for confounders, only prior GDM, a higher HbA1c level, macrosomia, and gestational term were found to significantly affect postpartum glucose tolerance. Although postpartum screening for T2DM is recommended for all women with GDM, a significant number of patients fail it. A better knowledge of predictive factors for this outcome is therefore needed for a more effective and targeted medical intervention.

Current views on the functional role of hydrogen and its kinetics in the human body

The purpose of this overview was to present historical data on the discovery of hydrogen and a brief summary of its physical properties that form the basis for its use in aeronautics. Information is provided on the use of hydrogen, a biologically neutral molecule, in medicine as a diagnostic indicator for penetrating wounds of the gastrointestinal tract, the determination of local blood flow using the hydrogen clearance method, the use of the hydrogen breath test for the diagnosis of malabsorption and carbohydrate intolerance, achlorhydria, the diagnosis of bacterial overgrowth syndrome, the assessment of biodegradation of magnesium-containing implants, the orocecal transit time, and during deep-sea diving. The reasons for the sharp increase in the doctors’ interest in studying the biological role of hydrogen after the discovery of its antioxidant properties by a group of Japanese scientists (2007) are analyzed. In order to increase antioxidant protection of the body, data from recent research on ways to increase its concentration in the body through the supply of exogenous gas by inhalation or by administering hydrogen-rich water or saline solution is presented. Particular attention is paid to a critical analysis of studies on the kinetics of hydrogen by different routes, its concentration in blood and tissues, inhalation, and the use of hydrogen-rich water. Based on an analysis of publications, that the use of molecular hydrogen to relieve oxidative stress in the tissues of the intestines, liver and lungs is most promising, since its highest concentration is found in these tissues. Fermentation of carbohydrates has also been shown to increase the production of hydrogen by the intestinal microbiota. Considering that a large number of molecular hydrogen generators appeared on the market, the data on the requirements for their safety are summarized. Considerations on the use of molecular hydrogen for the purpose of antioxidant protection of the body in cardiology, gastroenterology, pulmonology, and other areas of medicine are based on modern views on the mechanisms of antioxidant, anti-apoptotic, cytoprotective, and anti-inflammatory effects of hydrogen. Particular attention is paid to the analysis of experimental and clinical research on the use of hydrogen in acute and chronic lung lesions, therapy of acute and chronic COVID-19 infection.Conclusion. Based on an analysis of the literature and our own data, a conclusion was drawn on the safety and prospects of the clinical use of molecular hydrogen in a wide range of concentrations in many diseases with the pathogenesis based on oxidative stress. In particular, the need for additional research was highlighted to clarify the regimen, frequency, duration and concentrations of hydrogen used, and a personalized approach to the combination of endogenous (from the intestinal microbiota) and exogenous hydrogen in various diseases.

Explaining the experience of breastfeeding in women with gestational diabetes and designing and implementing an educational program based on planned behavior theory: a combined exploratory study protocol.

Gestational diabetes is a type of carbohydrate intolerance that is diagnosed for the first time during pregnancy. Researches have shown that gestational diabetes is associated with many negative prenatal and birth outcomes. Because of the complications such as infant death, several diabetics' mothers plan to stop breastfeeding. Research findings indicate a decrease in breastfeeding in mothers with gestational diabetes/ or contradictory tissues regarding the factors affecting the breastfeeding behavior of mothers with gestational diabetes and a special program to promote breastfeeding for these mothers based on the social and cultural conditions of Iranian society. The present study aims to design an interventional program with a mixed qualitative study based on the theory of planned behavior (PBT) to prevent the decrease of breastfeeding in diabetic mothers. A mixed methods exploratory design will be used to conduct this study in 3 phases. The first phase (qualitative): The purpose of the first phase is to understand the experience of breastfeeding mothers who had gestational diabetes, which will be done using the directed content analysis method. The purposive sampling will be used on pregnant mothers with gestational diabetes 30-34weeks and mothers with infants (up to 6months) with a history of gestational diabetes. The second phase include designing and implementing an educational program based on the PBT: Education will be conducted based on the needs assessment of the qualitative phase, the opinions of the focus group, and the literature review, then the breastfeeding behavior will be measured using the survey tool of "breastfeeding drop". The third phase: Interventional quantitative phase: The sample size will be carried out by a pilot study, then a designed program as an educational intervention for teaching breastfeeding behavior based on the PBT for 30-34weeks pregnant mothers with gestational diabetes will be implemented during 3-4 sessions and breastfeeding behavior will be evaluated after delivery. This is the first mixed-method study in Iran that led to implement an interventional program based on the theory of planned behavior. Because of the complications such as infant death, several diabetics' mothers plan to stop breastfeeding. We hope that the result of this research will be a step in solving breastfeeding problems in mothers with gestational diabetes.

High fat intake sustains sorbitol intolerance after antibiotic-mediated Clostridia depletion from the gut microbiota

Carbohydrate intolerance, commonly linked to the consumption of lactose, fructose, or sorbitol, affects up to 30% of the population in high-income countries. Although sorbitol intolerance is attributed to malabsorption, the underlying mechanism remains unresolved. Here, we show that a history of antibiotic exposure combined with high fat intake triggered long-lasting sorbitol intolerance in mice by reducing Clostridia abundance, which impaired microbial sorbitol catabolism. The restoration of sorbitol catabolism by inoculation with probiotic Escherichia coli protected mice against sorbitol intolerance but did not restore Clostridia abundance. Inoculation with the butyrate producer Anaerostipes caccae restored a normal Clostridia abundance, which protected mice against sorbitol-induced diarrhea even when the probiotic was cleared. Butyrate restored Clostridia abundance by stimulating epithelial peroxisome proliferator-activated receptor-gamma (PPAR-γ) signaling to restore epithelial hypoxia in the colon. Collectively, these mechanistic insights identify microbial sorbitol catabolism as a potential target for approaches for the diagnosis, treatment, and prevention of sorbitol intolerance.

Evaluation of serum placenta-specific gene 8 protein, total antioxidant capacity, interleukin-10, interleukin-17A, interleukin-21 and interleukin-33 levels in Turkish women with gestational diabetes mellitus

PurposeGestational diabetes mellitus (GDM) is defined as carbohydrate intolerance that begins or is diagnosed during pregnancy. Our study aimed to establish a correlation between proinflammatory and anti-inflammatory response in order to be able to develop treatment strategies and determine early diagnosis biomarkers in the sera of cases diagnosed with GDM. Moreover, we aimed to investigate interleukin (IL), placenta-specific gene 8 protein (PLAC8) and total antioxidant capacity (TAC) in patients with GDM. MethodsA total of 121 patients were included in the study. These were divided into four patient groups: pregnant and diagnosed with DM (P-GDM, n=30); pregnant and not diagnosed with DM (P-NGDM, n=32); non-pregnant diagnosed with DM (NP-DM, n=29) and non-pregnant and not diagnosed with DM (NPNDM, n=30). IL-10, IL-17A, IL-21, IL-33, PLAC8 and TAC determinations from patients were evaluated by ELISA (Enzyme-Linked ImmunoSorbent Assay) method. ResultsIL-10 and IL-33 concentrations were found to be significantly higher in P-GDM and NP-DM patient groups compared to P-NGDM and NP-NDM groups (p<0.001). The PLAC8 level in the P-GDM patient group (20.38±5.37) was determined to be significantly higher than in the P-NGDM patient group (3.41±2.17, p<0.001). TAC in the P-NGDM and NP-NDM groups (12.42±2.31 vs. 12.96±3.78, p<0.001) was determined to be significantly higher than in the P-GDM and NP-DM groups (4.8±0.52 vs. 2.21±0.71, p<0.001). DiscussionThe fact that the importance of PLAC8 level and TAC in the diagnosis and follow-up of GDM in pregnancy is demonstrated for the first time in this study shows that it is unique.

Evaluation of serum placenta-specific gene 8 protein, total antioxidant capacity, interleukin-10, interleukin-17A, interleukin-21 and interleukin-33 levels in Turkish women with gestational diabetes mellitus

PurposeGestational diabetes mellitus (GDM) is defined as carbohydrate intolerance that begins or is diagnosed during pregnancy. Our study aimed to establish a correlation between proinflammatory and anti-inflammatory response in order to be able to develop treatment strategies and determine early diagnosis biomarkers in the sera of cases diagnosed with GDM. Moreover, we aimed to investigate interleukin (IL), placenta-specific gene 8 protein (PLAC8) and total antioxidant capacity (TAC) in patients with GDM. MethodsA total of 121 patients were included in the study. These were divided into four patient groups: pregnant and diagnosed with DM (P-GDM, n=30); pregnant and not diagnosed with DM (P-NGDM, n=32); non-pregnant diagnosed with DM (NP-DM, n=29) and non-pregnant and not diagnosed with DM (NPNDM, n=30). IL-10, IL-17A, IL-21, IL-33, PLAC8 and TAC determinations from patients were evaluated by ELISA (Enzyme-Linked ImmunoSorbent Assay) method. ResultsIL-10 and IL-33 concentrations were found to be significantly higher in P-GDM and NP-DM patient groups compared to P-NGDM and NP-NDM groups (p<0.001). The PLAC8 level in the P-GDM patient group (20.38±5.37) was determined to be significantly higher than in the P-NGDM patient group (3.41±2.17, p<0.001). TAC in the P-NGDM and NP-NDM groups (12.42±2.31 vs. 12.96±3.78, p<0.001) was determined to be significantly higher than in the P-GDM and NP-DM groups (4.8±0.52 vs. 2.21±0.71, p<0.001). DiscussionThe fact that the importance of PLAC8 level and TAC in the diagnosis and follow-up of GDM in pregnancy is demonstrated for the first time in this study shows that it is unique.

The role of advanced glycation end products in sarcopenia in CKD patients

The accumulation of glycation end products (AGEs) is closely related to chronic inflammation, oxidative stress and can affect muscle function. An increase of the concentration of AGEs in the serum can be observed in patients already at the initial stages of the formation of chronic kidney disease (CKD). At the same time, there is no need for a violation of carbohydrate tolerance or diabetes mellitus. Sarcopenia is one of the complications of CKD. Its development in CKD can be considered not only as a result of endogenous intoxication, but also as one of the variants of premature aging. This literature review is devoted to the analysis of the mechanisms of the influence of AGEs on the occurrence and progression of sarcopenia in CKD.

Genetic and Epigenetic Factors in Gestational Diabetes Mellitus Pathology

Gestational diabetes (GDM) is the carbohydrate intolerance occurring during pregnancy. The risk factors of GDM include obesity, advanced maternal age, polycystic ovary syndrome, multigravidity, a sedentary lifestyle, and pre-existing hypertension. Additionally, complex genetic and epigenetic processes are also believed to play a crucial role in the development of GDM. In this narrative review, we discuss the role of genetic and epigenetic factors in gestational diabetes mellitus pathogenesis.

A Study to Assess the Effectiveness of Structured Teaching Programme on knowledge of Skill Associated to Self-Administration of Insulin among Gestational Diabetic Women Attending different hospitals of District Budgam, Kashmir

Gestational Diabetes Mellitus (GDM) is a form of diabetes occurring during pregnancy which can result in short- and long-term adverse outcomes for women and babies. GDM is carbohydrate intolerance resulting in hyperglycemia with onset or first recognition during pregnancy. Accurate diagnosis allows appropriate treatment. A pre experimental one group pre-test post-test design with non-probability purposive sampling technique was used.

Methods of treating gestational diabetes through an adapted diet and physical activity

Gestational diabetes mellitus (GDM) is a carbohydrate tolerance disorder that results in elevated blood glucose levels and was first recognized during pregnancy. Diabetes is the most common metabolic complication that complicates pregnancy. Therefore, it is important to quickly diagnose and prevent the effects of diabetes, which may arise in the mother and fetus. The occurrence of diabetes during pregnancy is a risk factor for diabetes and cardiovascular diseases later in life. Studies have shown a reduction in complications in patients with gestational diabetes after personalized health education in the field of nutrition. All pregnant women should be screened for impaired glucose tolerance as soon as possible after pregnancy is diagnosed. In the risk group, additionally, a 75g OGTT test should be performed on the first visit. Gestational diabetes affects one in ten pregnant women worldwide, and this percentage is increasing day by day. The main goal is to strive, during therapy, to equalize the glycemic value. The aim of this publication is to present the diagnostic process and, most importantly, the treatment of diabetes diagnosed in pregnancy. The publication focuses on gestational diabetes treated with an adapted diet, exercise and lifestyle changes. This publication describes how to create a balanced diet with a low glycemic index and how to choose physical exercise for a patient with gestational diabetes.

Significance of the rs754635 variant of the cholecystokinin gene in the development of obesity in children

So far, the possible influence of single nucleotide variants (SNV) of the cholecystokinin (CCK) gene on the likelihood of developing obesity and metabolic disorders in children has not been demonstrated. The aim of the study SNV associations of the CSK gene to predict the probability of obesity and personalize the development trajectory of various metabolic disorders associated with obesity in children. Materials and methods. 252 obese children aged 6-18 years were examined. The main group (n=152) was represented by children with metabolically unhealthy obesity (MUO). The control group (n=100) consolidated of children with metabolically healthy obesity (MHO). Whole genome sequencing (CeGat, Germany) was performed in 31 children of the main and 21 children of the control group. Serum levels of interleukin-1β were measured using a chemiluminescent immunoassay (CLIA) method, interleukin-6 - by enzyme-linked immunosorbent assay (ELISA), Synevo, Ukraine. Results. The G allele of SNV rs754635 of the CCK gene was significantly more frequent among children with both MHO (t=10.93; p&lt;0.05) and MUO (t=12.96; p&lt;0.05) compared to healthy individuals. The G allele of SNV rs754635 of the CCK gene was associated with basal hyperglycemia (r=0.44) and impaired carbohydrate tolerance (r=0.33) in the MHO phenotype and with the atherogenicity index of the lipid spectrum (r=0.40) and was inversely correlated with the level of high-density lipoproteins (HDL) (r=-0.58) in children with MUO phenotype, p&lt;0.05. Conclusions. The G allele SNV rs754635 of the CCK gene is associated with obesity and the development of metabolic disorders. The research was carried out in accordance with the principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the work. Informed consent of parents or their guardians was obtained for conducting research. No conflict of interests was declared by the author.