Intermittent fasting is increasing in popularity as a means of losing weight and controlling chronic illness. Patients with diabetes mellitus, both types 1 and 2, comprise about 10% of the population in the United States and would likely be attracted to follow one of the many methods of intermittent fasting. Studies on the safety and benefits of intermittent fasting with diabetes are very limited though, and health recommendations unfortunately today arise primarily from weight loss gurus and animal studies. Medical guidelines on how to manage therapeutic intermittent fasting in patients with diabetes are non-existent. The evidence to build such a clinical guideline for people with a diabetes diagnosis is almost non-existent, with just one randomized trial and several case reports. This article provides an overview of the available knowledge and a review of the very limited pertinent literature on the effects of intermittent fasting among people with diabetes. It also evaluates the known safety and efficacy issues surrounding treatments for diabetes in the fasting state. Based on those limited data and a knowledge of best practices, this paper proposes expert-based guidelines on how to manage a patient with either type 1 or 2 diabetes who is interested in intermittent fasting. The safety of each relevant pharmaceutical treatment during a fasting period is considered. When done under the supervision of the patient’s healthcare provider, and with appropriate personal glucose monitoring, intermittent fasting can be safely undertaken in patients with diabetes.

In recent years, active metasurfaces have emerged as a reconfigurable nanophotonic platform for the manipulation of light. Here, application of an external stimulus to resonant subwavelength scatterers enables dynamic control over the wavefront of reflected or transmitted light. In principle, active metasurfaces are capable of controlling key characteristic properties of an electromagnetic wave, such as its amplitude, phase, polarization, spectrum, and momentum. A ‘universal’ active metasurface should be able to provide independent and continuous control over all characteristic properties of light for deterministic wavefront shaping. In this article, we discuss strategies for the realization of this goal. Specifically, we describe approaches for high performance active metasurfaces, examine pathways for achieving two‐dimensional control architectures, and discuss operating configurations for optical imaging, communication, and computation applications based on a universal active metasurface.

Active metasurfaces designed to operate at optical frequencies are flat optical elements that can dynamic, subwavelength‐scale wavefront control of reflected or transmitted light. The practical and fundamental power‐handling limits of active metasurfaces at high pulse energies and high average powers determine the potential applications for these emerging photonic components. Here, we investigate thermal performance limits of reflective gate‐tunable conducting oxide metasurfaces illuminated with high power density laser beams, for both continuous wave (CW) and pulsed laser illumination. Our gate‐tunable metasurfaces use indium tin oxide (ITO) as an active material, which undergoes an epsilon‐near‐zero (ENZ) transition under applied electrical bias. We experimentally show that under CW illumination, there is no significant change in the electrically tunable metasurface optical response for high irradiances ranging from 1.6 kW/cm ² to 9.1 kW/cm ² when the illuminating laser beam diameter is 7 μm. Even under an applied bias, when over 60% of the incoming light is absorbed in a 1 nm–thick charge accumulation layer within ITO, the local temperature rise in the metasurface is modest, supporting its robustness for high‐power applications. Additionally, we theoretically show that in the ENZ regime, the metasurface reflectance can be increased by a factor of 10 by replacing the active ITO layer with cadmium oxide (CdO). Thus conducting oxide metasurfaces can tolerate the power densities needed in higher power applications, including free space optical communications, to light detection and ranging (LiDAR), as well as laser‐based additive manufacturing.

Background/Objectives: Providing relevant, patient-centered care starts with recognizing that patients living with diabetes are racially and ethnically diverse, which will influence their dietary behaviors. Methods: The authors draw upon literature descriptions and personal experience in clinical practice dealing with ethnically diverse populations and include guidance offered in the literature regarding how to address these unique aspects when managing and educating patients with diabetes. Results: Proper interviewing techniques are described when dealing with culturally diverse populations, including ascertaining cultural, religious, and ethnic influences on dietary choices, and advice is given on how to improve nutritional behavior in these patients while acknowledging and validating these influences. Conclusions: When a proper nutrition interview is conducted, such as using motivational interviewing, aspects of the patient’s cultural, religious, ethnic, and other influences can be ascertained, and appropriate advice can be given to the patient on how to modify these influences to achieve a healthier nutritional behavior.