Type 1 Diabetes and Exercise

This study aimed to: (1) assess Escherichia coli contamination in polony, beef burgers and traditionally fermented cow milk from the formal and informal markets in Harare, Zimbabwe, (2) determine the antibiotic sensitivity of Escherichia coli isolates, and (3) identify Shiga-toxin producing Escherichia coli isolates using the presence of virulence genes, namely, intimin, enterohemolysin A and Shiga toxins 1 and 2. Ninety-six samples comprising 32 beef polony slices, 32 beef burger patties, and 32 fermented milk specimens were obtained from the informal and formal outlets of the central business district. Escherichia coli occurred in 20 (21%) of the samples, being more prevalent in the informal (29%) than in the formal (13%) market. Of the 20 E. coli isolates, 6 (30%) were Shiga-toxin producing E. coli, and the rest (70%) were negative for virulence genes. The predominance of Escherichia coli was greater in meat products (25%) than in fermented milk (13%). Total Escherichia coli counts were not substantially different between formal and informal markets (t-test: p=0.08). All the E. coli isolates were multidrugresistant with antimicrobial resistance prevalence ranging from 25% for Sulphamethoxazole to 100% for Penicillin and Erythromycin. The presence of E. coli in food indicates faecal contamination and probable existence of other enteric pathogens. The presence of virulent and antimicrobial-resistant E. coli strains in food threatens food safety and public health. We conclude that ready-to-eat animal products from both informal and formal sectors could result in the dissemination of antimicrobialresistant Escherichia coli species if corrective measures are not taken.

Background: Recreational scuba diving has been authorized for type 1 diabetics over 18 years old – the age
of majority in France – since 2004, but it remained forbidden for younger diabetics by the French underwater federation (FFESSM). Here, we present a study to evaluate:
– the conditions under which diving could be authorized for 14- to 18 year olds with type 1 diabetes;
– the value of continuous glucose monitoring (CGM) while diving. A secondary objective was to monitor the impact of diving on the teenagers’ quality of life.
Subject and methods: Sixteen adolescents (14–17.5 years old) were included. Diabetes was known for 6 years (range, 1–14) and Hb1Ac was 9.0% (range, 7.7–11.9). The study was conducted in Mayotte with both capillary glycemia (CG) and CGM measurements taken during five dives.
Results: The average CG prior to diving was 283 mg/dL and decreased by 75 +or- 76 mg/dL during the dive.
No hypoglycemia occurred during the dives and four episodes occurred after. Glycemia variations during
dives and for the overall duration of the study were greater than for adults, most likely due to the general
adolescent behavior, notably regarding diet and diabetes management. CGM was greatly appreciated by the
adolescents. They had an overall satisfactory quality of life. No significant variations were observed during
the entire course of the study.
Conclusions: Although in need of further studies, these preliminary results show that CGM can be used
while diving. CGM records show a continuous decrease of glycemia during dives. Based on these results,
the French underwater federation has now authorized diving for adolescent type 1 diabetics following a specific diving protocol that includes HbA1c < 8.5%, autonomous management of diabetes by the adolescent, reduction of insulin doses, and target glycemia prior to the dive > 250 mg/dL.