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Background: Hyperglycemia in pregnancy (HIP) is a common medical complication during pregnancy and is associated with several short and long-term maternal-fetal consequences. We aimed to determine the prevalence and factors associated with HIP among Ugandan women.

Methods: We consecutively enrolled eligible pregnant women attending antenatal care at Kawempe National Referral Hospital, Kampala, Uganda in September 2020. Mothers known to be living with diabetes mellitus or haemoglobinopathies and those with anemia (hemoglobin <11g/dl) were excluded. Random blood sugar (RBS) and glycated hemoglobin A1c (HbA_1c) were measured on peripheral venous blood samples. HIP was defined as an HbA1c ≥5.7% with its subsets of diabetes in pregnancy (DIP) and prediabetes defined as HbA1c_1c of ≥6.5% and 5.7–6.4% respectively. ROC curve analysis was performed to determine the optimum cutoff of RBS to screen for HIP.

Results: A total of 224 mothers with a mean (±SD) age 26±5 years were enrolled, most of whom were in the 2^nd or 3^rd trimester (94.6%, n=212) with a mean gestation age of 26.6±7.3 weeks. Prevalence of HIP was 11.2% (n=25) (95% CI: 7.7–16.0). Among the mothers with HIP, 2.2% (n=5) had DIP and 8.9% (n=20) prediabetes. Patients with HIP were older (28 years vs. 26 years, p=0.027), had previous tuberculosis (TB) contact (24% vs. 6.5%, p=0.003) and had a bigger hip circumference (107.8 (±10.4) vs. 103.3 (±9.7) cm, p=0.032). However only previous TB contact was predictive of HIP (odds ratio: 4.4, 95% CI: 1.2–14.0; p=0.022). Using HbA_1c as a reference variable, we derived an optimum RBS cutoff of 4.75 mmol/L as predictive of HIP with a sensitivity and specificity of 90.7% and 56.4% (area under the curve=0.75 (95% CI: 0.70–0.80, p<0.001)), respectively.

Conclusions: HIP is common among young Ugandan women, the majority of whom are without identifiable risk factors.

In the state of Hawaii, it has been shown that certain ethnic minority groups, such as Filipinos and Pacific Islanders, suffer disproportionally high rates of cardiovascular disease, evidence that local health-care systems and governing bodies fail to equally extend the human right to health to all. This study aims to examine whether these ethnic health disparities in cardiovascular disease persist even within an already globally disadvantaged group, the houseless population of Hawaii.

A retrospective chart review of records from Hawaii Houseless Outreach and Medical Education Project clinic sites from 2016 to 2020 was performed to gather patient demographics and reported histories of type II diabetes, obesity, hyperlipidemia, hypertension and other cardiovascular disease diagnoses. Reported disease prevalence rates were compared between larger ethnic categories as well as ethnic subgroups.

Unexpectedly, the data revealed lower reported prevalence rates of most cardiometabolic diseases among the houseless compared to the general population. However, multiple ethnic health disparities were identified, including higher rates of diabetes and obesity among Native Hawaiians and other Pacific Islanders and higher rates of hypertension among Filipinos and Asians overall. The findings suggest that even within a generally disadvantaged houseless population, disparities in health outcomes persist between ethnic groups and that ethnocultural considerations are just as important in caring for this vulnerable population.

To the best of the authors’ knowledge, this is the first comprehensive study focusing on ethnic health disparities in cardiovascular disease and the structural processes that contribute to them, among a houseless population in the ethnically diverse state of Hawaii.

The purpose of this study is to collect and assess the evidence available on the effect of non nutritive sweeteners on appetite, weight and glycemic regulation. As a replacement for sugars, non-nutritive sweeteners (NNSs) are widely being used in different food products with the assumption that these would lower calorie intake and help to manage weight and blood sugar levels better. However, studies using animal models have reported that chronic exposure to NNSs leads to increased food consumption, weight gain and insulin resistance.

Evidence was acquired from systematic reviews or meta-analyses (2016–2021) of relevant clinical studies, especially randomized control trials using Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines.

The review showed NNSs exposure did not conclusively induce increased food intake or change in subjective appetite ratings. Appetite biomarkers like ghrelin, gastric inhibitory peptide, C-peptide levels and Peptide YY remained mostly unaffected by NNSs. Meta-analyses of human randomized control studies showed a reduced energy intake and body weight. No significant change was seen in blood glucose levels, post-prandial glycemic or insulin response after consumption of NNSs. Adequate evidence is not available to conclusively say that NNSs influence gut health at doses relevant to human use.

Most studies which are prospective cohort, observational and cross-sectional studies suggest that use of NNSs may promote obesity and metabolic syndrome in adults. Such studies are plagued by confounding variables and reverse causation. Mechanistic evidence is mostly based on in-vitro and in-vivo studies. The same causal pathways may not be operative or relevant in humans.

This review of available literature concludes that to achieve specific public health and clinical goals, the safe use of NNSs for the reduction of intakes of free sugars and energy should be explored. This would be possible by educating the consumer about energy compensation and understanding the nutritional content of artificially sweetened products in terms of calories coming from fat and complex carbohydrates used in the product.

This study was, thus, designed with the objective of examining the usefulness of NNSs in human population, especially with respect to insulin regulation, glycemic control and weight management. Well-designed randomized control trials which control for confounding variables are needed to generate high quality evidence.

People living with severe mental illness (PLWSMI) experience disproportionately high rates of morbidity and mortality compared with the general population. Sydney Local Health District (SLHD) introduced the Living Well, Living Longer integrated care program in 2013 to address this inequity. This paper reports on the impact of the COVID-19 pandemic on the provision of physical health interventions to community mental health consumers in SLHD.

Rates of COVID-19 vaccinations were collated. Routinely collected service data were reviewed for changes in rates of metabolic monitoring, mental health shared care, physical health checks, cardiometabolic health clinic assessments and diet and exercise interventions.

91.9% of consumers received at least two COVID-19 vaccinations and 61.3% received a booster. However, there was a 37.3% reduction in rates of metabolic monitoring, 20.1% reduction in Mental Health Shared Care agreements, 60.6% reduction in physical health checks with general practitioners, 65.4% reduction in cardiometabolic clinic assessments and 19.8% reduction of diet and exercise interventions.

The impact of the pandemic may lead to an exacerbation of poorly managed comorbid disease and increased premature mortality in people living with severe mental illness. Service providers should consider the local impact of the pandemic on the provision of physical health interventions and ensure steps are taken to address any deficits.

There is a paucity of published analysis regarding the impact of the pandemic on the provision of physical health interventions to people living with severe mental illness.

Meteorin like-peptide (Metrnl) modulates energy hemostasis and relieves inflammation and oxidative stress. This study aims to investigate the relationship between Metrnl levels and inflammatory cytokines, oxidative stress biomarkers and body composition parameters in obese type 2 diabetic patients.

This analytical cross-sectional study was carried out between August 2020 and March 2021on 93 people (n = 32 obese type 2 diabetic patients, n = 31 healthy obese, n = 30 healthy normal weight). Serum Metrnl levels were measured by enzyme-linked immunosorbent assay. Serum levels of interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-α), high-sensitivity C-reactive protein (hs-CRP), malondialdehyde and total antioxidant capacity were measured using standard methods. Body composition was assessed by bioelectrical impedance analysis. p-Value less than 0.05 was considered significant.

Serum Metrnl levels were lower in obese diabetic patients than in healthy normal-weight subjects (82.5 [72.4–94.5] ng/mL compared to 154 [129–189] ng/mL). The difference in Metrnl levels between the two groups was significant (p < 0.001). The difference in Metrnl levels between the two groups was significant. Moreover, a significant correlation between Metrnl level and both TNF-a and hs-CRP was detected (p = 0.006 and p < 0.001, respectively) and the correlation between Metrnl and IL-6 was borderline (p = 0.051). A negative correlation was revealed between Metrnl level and anthropometric measurements and body composition (p < 0.05) with the exception of fat-free mass and skeletal muscle mass.

To discover sufficient evidence for the therapeutic function of Metrnl and its use as a prognostic biomarker in the management of type 2 diabetes mellitus, future clinical studies are needed to highlight other factors influencing Metrnl serum levels.