Medical nutrition therapy (MNT) is a vital aspect of management of type 1 diabetes mellitus (T1DM) and should be tailored to ethnic and family traditions and the socioeconomic and educational status of the patient. In this article, we discuss the unique aspects of MNT in children and adolescents with T1DM in the Indian setting, with focus on the challenges faced by patients, dieticians and physicians and how these can be overcome. The authors reviewed the available literature on MNT in T1DM from India and prepared the document based on their vast collective clinical experience in treating patients with T1DM from different regions in India. Indian diets are predominantly carbohydrate‐based with high glycemic index (GI) and low protein content. Various methods are available to increase the protein and fiber content and reduce the GI of food in order to limit glycemic excursions. Insulin regimens need to be tailored to the child's school timings, meal schedule, and the availability of a responsible adult to supervise/administer insulin. All patients, irrespective of economic and education background, should be taught the broad principles of healthy eating, balanced diet and carbohydrate counting. There are various barriers to dietary compliance, including joint family system, changing lifestyles, and other factors which need to be addressed. There is a need to customize dietary management according to patient characteristics and needs and develop standardized patient educational material on principles of healthy eating in various regional languages.

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SUMMARY Reverse triiodothyronine (rT3), triiodothyronine (T3), thyroxine (T4), and thyroid stimulating hormone (TSH) values were measured by radioimmunoassay in 40 children with congenital hypothyroidism who were being given levothyroxine (0.05-0*35 mg/day) and in 14 normal controls. The serum T3 and T4 concentrations were estimated using kits prepared by BARC (Bhabha Atomic Research Centre), India. The minimal detectable value for T3 was 0-125 ng/ml and for T4 was 1.2 ng/ml. Quality control was maintained by using pooled serum dispensed in small vials and preserved at -20°C: one of these was assayed with every batch. The tests and standards were run in duplicate. The interassay percent coefficient of variation was 10.9 for T3 and 7.9 for T4. rT3 was estimated by radioimmunoassay (RIA) (code 1834 Hypolab A A Coinsins, Switzerland). The RIA kit contained a quality control test, and the sensitivity of the assay was 0-06 ng/ml. The TSH was estimated by RIA using the double antibody technique of Midglay. Reagents were kindly supplied by the National Institute of Health, Bethesda, USA. The sensitivity of the TSH assay system was 1 ,uU/ml.

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