Diabetes-Specific Nutrition Algorithm: A Transcultural Program to Optimize Diabetes and Prediabetes Care

Type 2 diabetes (T2D) and prediabetes have a major global impact through high disease prevalence, significant downstream pathophysiologic effects, and enormous financial liabilities. To mitigate this disease burden, interventions of proven effectiveness must be used. Evidence shows that nutrition therapy improves glycemic control and reduces the risks of diabetes and its complications. Accordingly, diabetes-specific nutrition therapy should be incorporated into comprehensive patient management programs. Evidence-based recommendations for healthy lifestyles that include healthy eating can be found in clinical practice guidelines (CPGs) from professional medical organizations. To enable broad implementation of these guidelines, recommendations must be reconstructed to account for cultural differences in lifestyle, food availability, and genetic factors. To begin, published CPGs and relevant medical literature were reviewed and evidence ratings applied according to established protocols for guidelines. From this information, an algorithm for the nutritional management of people with T2D and prediabetes was created. Subsequently, algorithm nodes were populated with transcultural attributes to guide decisions. The resultant transcultural diabetes-specific nutrition algorithm (tDNA) was simplified and optimized for global implementation and validation according to current standards for CPG development and cultural adaptation. Thus, the tDNA is a tool to facilitate the delivery of nutrition therapy to patients with T2D and prediabetes in a variety of cultures and geographic locations. It is anticipated that this novel approach can reduce the burden of diabetes, improve quality of life, and save lives. The specific Southeast Asian and Asian Indian tDNA versions can be found in companion articles in this issue of Current Diabetes Reports

Detection and identification of a group 16SrIII-related phytoplasma associated with coffee crispiness disease in Colombia

Coffee crispiness (“crespera”), a disease of uncertain etiology, has been endemic in coffee (Coffea arabica L.) plantations in Colombia for at least 60 years. Symptoms typically consist of bud proliferation, abundant short and narrow leaves, phyllody, floral abortion, monospermic fruit, and dwarfing of plants. In severe cases, coffee crispiness disease (CCD) can affect production significantly. In this study, association of a phytoplasma with CCD was indicated by the accumulation of Diene's stain, or 4?, 6-diamidino-2-phenylindole fluorescence, only in phloem of affected plant tissues. The presence of polymorphic phytoplasma cells in phloem sieve tube elements was confirmed by transmission electron microscopy. The disease was transmitted successfully by grafting symptomatic shoots from CCD-affected C. arabica plants onto young, healthy rootstocks; however, symptoms failed to develop after mechanical inoculation of young plants with extracts derived from diseased plant tissues. A nested polymerase chain reaction (PCR) assay employing primer pairs P1/P7 followed by FU5/rU3 amplified a 16S ribosomal DNA product (941 bp) exclusively from DNA of diseased plants. Sequence and phylogenetic analysis of the nested PCR product identified the CCD phytoplasma as a new strain member of group 16SrIII (X-disease group). This is the first report of a phytoplasma infecting coffee plants