Research

11 pages, 513 KiB

Open AccessArticle

One-Hour Post-Load Plasma Glucose and Altered Glucometabolic Profile in Youths with Overweight or Obesity

by Procolo Di Bonito, Giuliana Valerio, Maria Rosaria Licenziati, Domenico Corica, Malgorzata Wasniewska, Anna Di Sessa, Emanuele Miraglia del Giudice, Anita Morandi, Claudio Maffeis, Enza Mozzillo, Valeria Calcaterra, Francesca Franco, Giulio Maltoni and Maria Felicia Faienza

Int. J. Environ. Res. Public Health 2023, 20(11), 5961; https://doi.org/10.3390/ijerph20115961 - 26 May 2023

Cited by 2 | Viewed by 1265

Abstract

In youths, two cut-offs (133 and 155 mg/dL) have been proposed to identify high glucose levels at the 1 h (G₆₀) mark during an oral glucose tolerance test (OGTT). We evaluated which cut-off was more closely associated with isolated impaired glucose [...] Read more.

In youths, two cut-offs (133 and 155 mg/dL) have been proposed to identify high glucose levels at the 1 h (G₆₀) mark during an oral glucose tolerance test (OGTT). We evaluated which cut-off was more closely associated with isolated impaired glucose tolerance (IGT) and cardiometabolic risk (CMR) in 1199 youth with overweight/obesity (OW/OB) and normal fasting glucose and/or HbA1c. The disposition index (DI) was available in 724 youths. The sample was divided by two cut-offs of G₆₀: <133 mg/dL (n = 853) and ≥133 mg/dL (n = 346), or G₆₀ < 155 mg/dL (n = 1050) and ≥155 mg/dL (n = 149). Independent of the cut-off, youths with high levels of G₆₀ showed higher levels of G₁₂₀, insulin resistance (IR), triglycerides to HDL ratio (TG/HDL), alanine aminotransferase (ALT), and lower insulin sensitivity (IS) and DI than youths with lower levels of G₆₀. The percentage of youths showing IGT, IR, low IS, high TG/HDL ratio, high ALT, and low DI was 50% higher in the G₆₀ ≥ 133 mg/dL group than in the G₆₀ ≥ 155 mg/dL one. In youths with OW/OB and IGT, a cut-off of G₆₀ ≥ 133 mg/dL is more useful than G₆₀ ≥ 155 mg/dL to identify those at high risk of IGT and altered CMR profile. Full article

(This article belongs to the Special Issue Diabetes: Screening, Prevention, Diagnosis and Therapy)

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9 pages, 546 KiB

Open AccessArticle

Which Is the Most Appropriate Cut-Off of HbA1c for Prediabetes Screening in Caucasian Youths with Overweight or Obesity?

by Procolo Di Bonito, Maria Rosaria Licenziati, Domenico Corica, Malgorzata Wasniewska, Anna Di Sessa, Emanuele Miraglia del Giudice, Anita Morandi, Claudio Maffeis, Maria Felicia Faienza, Enza Mozzillo, Valeria Calcaterra, Francesca Franco, Giulio Maltoni and Giuliana Valerio

Int. J. Environ. Res. Public Health 2023, 20(2), 928; https://doi.org/10.3390/ijerph20020928 - 04 Jan 2023

Cited by 5 | Viewed by 1444

Abstract

This cross-sectional study aimed to assess the best cut-off of HbA1c for detection of impaired fasting glucose (IFG), impaired glucose tolerance (IGT), beta-cell impairment and cardiometabolic risk (CMR) profile in overweight or obese (OW/OB) Caucasian youths. Two-hour oral glucose tolerance test was available [...] Read more.

This cross-sectional study aimed to assess the best cut-off of HbA1c for detection of impaired fasting glucose (IFG), impaired glucose tolerance (IGT), beta-cell impairment and cardiometabolic risk (CMR) profile in overweight or obese (OW/OB) Caucasian youths. Two-hour oral glucose tolerance test was available in 1549 youths, one-hour glucose (G₆₀) in 1430 youths and disposition index (DI) in 972 youths. Insulin resistance (IR) was calculated as Homeostatic Model Assessment for IR and insulin sensitivity (IS) as 1/fasting insulin. High G₆₀ was defined by a value ≥ 133 mg/dL. The best cut-off of HbA1c for IFG or IGT was 5.5%. The frequency of individuals with HbA1c ≥ 5.5% was 32.5%, compared to 16.3% with HbA1c ≥ 5.7% (as proposed by the American Diabetes Association). HbA1c ≥ 5.5% showed higher sensitivity and lower specificity with respect to HbA1c ≥ 5.7% for all the abnormalities examined (IFG, IGT, high G₆₀, IR, low IS, DI and CMR factors). In conclusion, this lower cut-off might represent a more appropriate screening marker of glucose dysmetabolism in youths with OW/OB. Prospective studies are needed to validate this cut-off for predicting prediabetes/diabetes in youths with OW/OB. Full article

(This article belongs to the Special Issue Diabetes: Screening, Prevention, Diagnosis and Therapy)

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15 pages, 1052 KiB

Open AccessArticle

Cost of Illness Analysis of Type 2 Diabetes Mellitus: The Findings from a Lower-Middle Income Country

by Muhammad Daoud Butt, Siew Chin Ong, Muhammad Umar Wahab, Muhammad Fawad Rasool, Fahad Saleem, Adnan Hashmi, Ahsan Sajjad, Furqan Aslam Chaudhry and Zaheer-Ud-Din Babar

Int. J. Environ. Res. Public Health 2022, 19(19), 12611; https://doi.org/10.3390/ijerph191912611 - 02 Oct 2022

Cited by 10 | Viewed by 3473

Abstract

Background: Diabetes is a major chronic illness that negatively influences individuals and society. Therefore, this research aimed to analyze and evaluate the cost associated with diabetes management, specific to the Pakistani Type 2 diabetes population. Research scheme and methods: A survey randomly collected [...] Read more.

Background: Diabetes is a major chronic illness that negatively influences individuals and society. Therefore, this research aimed to analyze and evaluate the cost associated with diabetes management, specific to the Pakistani Type 2 diabetes population. Research scheme and methods: A survey randomly collected information and data from diabetes patients throughout Pakistan out-patient clinics. Direct and indirect costs were evaluated, and data were analyzed with descriptive and inferential statistics. Results: An overall of 1839 diabetes patients participated in the study. The results have shown that direct and indirect costs are positively associated with the participants’ socio-demographic characteristics, except for household income and educational status. The annual total cost of diabetes care was USD 740.1, amongst which the share of the direct cost was USD 646.7, and the indirect cost was USD 93.65. Most direct costs comprised medicine (USD 274.5) and hospitalization (USD 319.7). In contrast, the productivity loss of the patients had the highest contribution to the indirect cost (USD 81.36). Conclusion: This study showed that direct costs significantly contributed to diabetes’s overall cost in Pakistan and overall diabetes management estimated to be 1.67% (USD 24.42 billion) of the country’s total gross domestic product. The expense of medications and hospitalization mostly drove the direct cost. Additionally, patients’ loss of productivity contributed significantly to the indirect cost. It is high time for healthcare policymakers to address this huge healthcare burden. It is time to develop a thorough diabetes management plan to be implemented nationwide. Full article

(This article belongs to the Special Issue Diabetes: Screening, Prevention, Diagnosis and Therapy)

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8 pages, 316 KiB

Open AccessArticle

Impact of Diabetes on Cardiac Function in Patients with High Blood Pressure

by Nabila Soufi Taleb Bendiab, Souhila Ouabdesselam, Latefa Henaoui, Marilucy Lopez-Sublet, Jean-Jacques Monsuez and Salim Benkhedda

Int. J. Environ. Res. Public Health 2021, 18(12), 6553; https://doi.org/10.3390/ijerph18126553 - 18 Jun 2021

Cited by 5 | Viewed by 2076

Abstract

Background: Although the combination of high blood pressure (HBP) and type 2 diabetes (T2DM) increases the risk of left ventricular (LV) dysfunction, the impact of T2DM on LV geometry and subclinical dysfunction in hypertensive patients and normal ejection fraction (EF) has been [...] Read more.

Background: Although the combination of high blood pressure (HBP) and type 2 diabetes (T2DM) increases the risk of left ventricular (LV) dysfunction, the impact of T2DM on LV geometry and subclinical dysfunction in hypertensive patients and normal ejection fraction (EF) has been infrequently evaluated. Methods: Hypertensive patients with or without T2DM underwent cardiac echocardiography coupled with LV global longitudinal strain (GLS) assessment. Results: Among 200 patients with HBP (mean age 61.7 ± 9.7 years) and EF > 55%, 93 had associated T2DM. Patients with T2DM had a higher body mass index (29.9 ± 5.1 kg/m² vs. 29.3 ± 4.7 kg/m², p = 0.025), higher BP levels (158 ± 23/95 ± 13 vs. 142 ± 33/87 ± 12 mmHg, p = 0.003), a higher LV mass index (115.8 ± 32.4 vs. 112.0 ± 24.7 g/m², p = 0.004), and higher relative wall thickness (0.51 ± 0.16 vs. 0.46 ± 0.12, p = 0.0001). They had more frequently concentric remodeling (20.4% vs. 16.8%, p < 0.001), concentric hypertrophy (53.7% vs. 48.6%, p < 0.001), elevated filling pressures (25.8 vs. 12.1%, p = 0.0001), indexed left atrial volumes greater than 28 mL/m² (17.2 vs. 11.2%, p = 0.001), and a reduced GLS less than −18% (74.2 vs. 47.7%, p < 0.0001). After adjustment for BP and BMI, T2DM remains an independent determinant factor for GLS decline (OR = 2.26, 95% CI 1.11–4.61, p = 0.023). Conclusions: Left ventricular geometry and subclinical LV function as assessed with GLS are more impaired in hypertensive patients with than without T2DM. Preventive approaches to control BMI and risk of T2DM in hypertensive patients should be emphasized. Full article

(This article belongs to the Special Issue Diabetes: Screening, Prevention, Diagnosis and Therapy)

11 pages, 465 KiB

Open AccessArticle

Hypertension Is Associated with Increased Risk of Diabetic Lung

by Jihyun Lee, Donghwan Kwon, Youngjang Lee, Inchan Jung, Daesung Hyun, Hunju Lee and Yeon-Soon Ahn

Int. J. Environ. Res. Public Health 2020, 17(20), 7513; https://doi.org/10.3390/ijerph17207513 - 15 Oct 2020

Cited by 4 | Viewed by 2131

Abstract

Lung function is often impaired in diabetic patients, especially in a restrictive pattern, which has recently been described as the diabetic lung. Since hypertension (HTN) is common in diabetic patients, our study investigated whether HTN acts as an aggravating factor in diabetic lung. [...] Read more.

Lung function is often impaired in diabetic patients, especially in a restrictive pattern, which has recently been described as the diabetic lung. Since hypertension (HTN) is common in diabetic patients, our study investigated whether HTN acts as an aggravating factor in diabetic lung. Within the cross-sectional study from the 6th Korean National Health and Nutrition Examination Survey (KNHANES), fasting plasma glucose (FPG), blood pressure (BP), pulmonary function, and laboratory data were examined in 4644 subjects aged between 40 and 79 years. A multivariate regression model was used to investigate the relationship between BP, FPG, and pulmonary function. Lung function was significantly reduced in the HTN (p = 0.001), impaired fasting glucose (IFG) (p < 0.001), and diabetes mellitus (DM) (p < 0.001) groups. Next, a multivariate logistic regression model was used to derive the odds ratio (OR) of reduced lung function based on the presence of IFG, DM, and HTN. The OR of reduced forced vital capacity (FVCp < 80%) was 3.30 (p < 0.001) in the HTN-DM group and 2.30 (p < 0.001) in the normal BP-DM group, when compared with the normal BP-normal FPG group. The combination of HTN and DM had the strongest negative effect on FVC. The results presented in this study indicate that diabetes and hypertension have a synergistic association with impaired lung function. Full article

(This article belongs to the Special Issue Diabetes: Screening, Prevention, Diagnosis and Therapy)

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8 pages, 529 KiB

Open AccessArticle

Gingival Crevicular Blood as a Potential Screening Tool: A Cross Sectional Comparative Study

by Biagio Rapone, Elisabetta Ferrara, Luigi Santacroce, Skender Topi, Ilaria Converti, Antonio Gnoni, Antonio Scarano and Salvatore Scacco

Int. J. Environ. Res. Public Health 2020, 17(20), 7356; https://doi.org/10.3390/ijerph17207356 - 09 Oct 2020

Cited by 41 | Viewed by 2472

Abstract

Background: Diabetes is known to be one of the major global epidemic diseases, significantly associated with mortality and morbidity worldwide, conferring a substantial burden to the health care system. The epidemiological transition of this chronic disease tends to worsen unless preventive health strategies [...] Read more.

Background: Diabetes is known to be one of the major global epidemic diseases, significantly associated with mortality and morbidity worldwide, conferring a substantial burden to the health care system. The epidemiological transition of this chronic disease tends to worsen unless preventive health strategies are implemented. Appropriate screening devices and standardized methods are crucial to prevent this potentially inauspicious life condition. Currently, the glucometer is the conventional device employed for blood glucose level determination that outputs the blood glucose reading. Glucometer performed in the dental office may be an important device in screening diabetes, so it can be addressed during a periodontal examination. Because gingival blood is a useful source to detect the glucose level, the focus is placed on the opportunity that might provide valuable diagnostic information. This study aimed to compare gingival crevicular blood with finger-stick blood glucose measurements using a self-monitoring glucometer, to evaluate whether gingival crevicular blood could be an alternative to allow accurate chairside glucose testing. Methods: A cross-sectional comparative study was performed among a 31–67-year-old population. Seventy participants with diagnosed type 2 diabetes and seventy healthy subjects, all with positive bleeding on probing, were enrolled. The gingival crevicular blood was collected using a glucometer to estimate the blood glucose level and compared with finger-stick blood glucose level. Results: The mean capillary blood glucose and gingival crevicular blood levels from all samples were, respectively, 160.42 ± 31.31 mg/dL and 161.64 ± 31.56 mg/dL for diabetic participants and 93.51 ± 10.35 mg/dL and 94.47 ± 9.91 mg/dL for healthy patients. In both groups, the difference between gingival crevicular blood and capillary blood glucose levels was non-significant (P < 0.05). The highly significant correlation between capillary blood glucose and gingival crevicular blood (r = 0.9834 for diabetic patients and r = 0.8153 for healthy participants) in both the groups was found. Conclusions: Gingival crevicular blood test was demonstrated as a feasible and useful primary screening tool test for detecting diabetes and for glucose estimation in non-diabetic patients. Use of gingival crevicular blood for screening is an attractive way of identifying a reasonable option of finger-stick blood glucose measurement under the appropriate circumstances. Rapid assessment may precede diagnostic evaluation in diabetic as well as healthy patients with acute severe bleeding. In addition, gingival crevicular blood levels may be needed to monitor the diabetic output. Full article

(This article belongs to the Special Issue Diabetes: Screening, Prevention, Diagnosis and Therapy)

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16 pages, 759 KiB

Open AccessArticle

Secondhand Smoke Correlates with Elevated Neutrophil-Lymphocyte Ratio and Has a Synergistic Effect with Physical Inactivity on Increasing Susceptibility to Type 2 Diabetes Mellitus: A Community-Based Case Control Study

by Yohanes Andy Rias, Christopher James Gordon, Shu Fen Niu, Bayu Satria Wiratama, Ching Wen Chang and Hsiu Ting Tsai

Int. J. Environ. Res. Public Health 2020, 17(16), 5696; https://doi.org/10.3390/ijerph17165696 - 06 Aug 2020

Cited by 8 | Viewed by 2896

Abstract

Secondhand smoke (SHS) and physical inactivity are thought to be associated with type 2 diabetes mellitus (T2DM), but the synergistic effect of SHS with physical inactivity and their relationships with T2DM–associated inflammation biomarkers have not been estimated. We investigated the roles of SHS [...] Read more.

Secondhand smoke (SHS) and physical inactivity are thought to be associated with type 2 diabetes mellitus (T2DM), but the synergistic effect of SHS with physical inactivity and their relationships with T2DM–associated inflammation biomarkers have not been estimated. We investigated the roles of SHS exposure and physical inactivity and their synergistic effect on T2DM risk and their relationships with T2DM associated inflammation biomarkers, neutrophil–lymphocyte ratio (NLR) and white blood cells (WBCs). A case–control study was conducted in total 588 participants (294 case T2DM and 294 healthy controls) from five community clinics in Indonesia. Participants completed a standardized questionnaire on demographic information, smoking status, physical activity habits and food consumption. WBCs and NLR levels were determined using an automated hematology analyzer. Adjusted odds ratios (AORs) and 95% confidence intervals (CIs) were analyzed using multiple logistic regression model. The synergistic effect was analyzed using additive interaction for logistic regression. Physical inactive people exposed to SHS exhibited a synergistically increased 7.78-fold risk of T2DM compared with people who were not exposed to SHS and who were physically active. SHS is significantly correlated with a high NLR, WBCs and has a synergistic effect with physical inactivity on increasing susceptibility to T2DM. Full article

(This article belongs to the Special Issue Diabetes: Screening, Prevention, Diagnosis and Therapy)

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12 pages, 2816 KiB

Open AccessArticle

The Effect of Gaseous Ozone Therapy in Conjunction with Periodontal Treatment on Glycated Hemoglobin Level in Subjects with Type 2 Diabetes Mellitus: An Unmasked Randomized Controlled Trial

by Biagio Rapone, Elisabetta Ferrara, Massimo Corsalini, Ilaria Converti, Felice Roberto Grassi, Luigi Santacroce, Skender Topi, Antonio Gnoni, Salvatore Scacco, Antonio Scarano and Maurizio Delvecchio

Int. J. Environ. Res. Public Health 2020, 17(15), 5467; https://doi.org/10.3390/ijerph17155467 - 29 Jul 2020

Cited by 59 | Viewed by 3568

Abstract

Background: It is established that inflammation is involved in the pathogenesis of Type 2 Diabetes Mellitus (T2DM) by promoting insulin resistance and impaired beta cell function in the pancreas. Among the hypothesized independent risk factors implicated in the pathogenetic basis of disease, periodontal [...] Read more.

Background: It is established that inflammation is involved in the pathogenesis of Type 2 Diabetes Mellitus (T2DM) by promoting insulin resistance and impaired beta cell function in the pancreas. Among the hypothesized independent risk factors implicated in the pathogenetic basis of disease, periodontal infection has been proposed to promote an amplification of the magnitude of the advanced glycation end product (AGE)-mediated upregulation of cytokine synthesis and secretion. These findings suggest an interrelationship between periodontal disease and type 2 diabetes, describing poor metabolic control in subjects with periodontitis as compared to nondiabetic subjects and more severe periodontitis in subjects with T2DM as compared to a healthy population, with a significant positive correlation between periodontal inflammatory parameters and glycated hemoglobin level. Results from clinical trials show that periodontal treatment is able to improve glycemic control in subjects with diabetes. Many therapeutic strategies have been developed to improve periodontal conditions in conjunction with conventional treatment, among which ozone (O₃) is of specific concern. The principal aim of this trial was to compare the clinical effectiveness of an intensive periodontal intervention consisting of conventional periodontal treatment in conjunction with ozone gas therapy in reducing glycated hemoglobin level in type 2 diabetic patients and standard periodontal treatment. Methods: This study was a 12-month unmasked randomized trial and included 100 patients aged 40–74 years older, with type 2 diabetes mellitus diagnosed. All the patients received conventional periodontal treatment, or periodontal treatment in conjunction with ozone gas therapy in a randomly assigned order (1:1). The primary outcome was a clinical measure of glycated hemoglobin level at 3, 6, 9 and 12 months from randomization. Secondary outcomes were changes in periodontal inflammatory parameters. Results: At 12 months, the periodontal treatment in conjunction with ozone gas therapy did not show significant differences than standard therapy in decreasing glycated hemoglobin (HbA1C) level and the lack of significant differences in balance is evident. Conclusions: Although the change was not significant, periodontal treatment in conjunction with the gaseous ozone therapy tended to reduce the levels of glycated hemoglobin. The study shows a benefit with ozone therapy as compared to traditional periodontal treatment. Full article

(This article belongs to the Special Issue Diabetes: Screening, Prevention, Diagnosis and Therapy)

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12 pages, 512 KiB

Open AccessArticle

Influence of Age on Partial Clinical Remission among Children with Newly Diagnosed Type 1 Diabetes

by Stefano Passanisi, Giuseppina Salzano, Albino Gasbarro, Valentina Urzì Brancati, Matilde Mondio, Giovanni Battista Pajno, Angela Alibrandi and Fortunato Lombardo

Int. J. Environ. Res. Public Health 2020, 17(13), 4801; https://doi.org/10.3390/ijerph17134801 - 03 Jul 2020

Cited by 21 | Viewed by 2874

Abstract

Partial clinical remission (PCR) is a transitory period characterized by the residual endogenous insulin secretion following type 1 diabetes (T1D) diagnosis and introducing the insulin therapy. Scientific interest in PCR has been recently increasing, as this phase could be crucial to preserve functional [...] Read more.

Partial clinical remission (PCR) is a transitory period characterized by the residual endogenous insulin secretion following type 1 diabetes (T1D) diagnosis and introducing the insulin therapy. Scientific interest in PCR has been recently increasing, as this phase could be crucial to preserve functional beta cells after T1D onset, also taking advantage of new therapeutic opportunities. The aim of this study was to assess the frequency, duration and associated factors of PCR in children newly diagnosed with T1D. Our cohort study included 167 pediatric patients aged 13.8 ± 4.1 years. The association of clinical and laboratory factors with the occurrence and duration of PCR was evaluated via logistic regression and multivariable generalized linear model, respectively. PCR occurred in 63.5% of the examined patients. Patients who achieved the remission phase were significantly older, and they had lower daily insulin requirement compared with non-remitters. PCR was positively associated to body mass index (OR = 1.11; p = 0.032), pH value (OR 49.02; p = 0.003) and c-peptide levels (OR 12.8; p = 0.002). The average duration of PCR was 13.4 months, and older age at diagnosis was the only predictor factor. Two years after diagnosis remitter patients had lower HbA1c and daily insulin requirement. Full article

(This article belongs to the Special Issue Diabetes: Screening, Prevention, Diagnosis and Therapy)

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Review

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15 pages, 1194 KiB

Open AccessReview

Prevention of Type 1 Diabetes in Children: A Worthy Challenge?

by Diletta Maria Francesca Ingrosso, Maria Teresa Quarta, Alessia Quarta and Francesco Chiarelli

Int. J. Environ. Res. Public Health 2023, 20(11), 5962; https://doi.org/10.3390/ijerph20115962 - 26 May 2023

Viewed by 3297

Abstract

Nowadays, the development of new immuno-therapeutic drugs has made it possible to alter the course of many autoimmune diseases. Type 1 diabetes is a chronic disease with a progressive dependence on exogenous insulin administration. The ability to intercept individuals at high risk of [...] Read more.

Nowadays, the development of new immuno-therapeutic drugs has made it possible to alter the course of many autoimmune diseases. Type 1 diabetes is a chronic disease with a progressive dependence on exogenous insulin administration. The ability to intercept individuals at high risk of developing type 1 diabetes is the first step toward the development of therapies that can delay the process of β-cell destruction, thus permitting a better glycemic control and reducing the incidence of ketoacidosis. The knowledge of the main pathogenetic mechanisms underlying the three stages of the disease may be helpful to identify the best immune therapeutic approach. In this review, we aim to give an overview of the most important clinical trials conducted during the primary, secondary and tertiary phases of prevention. Full article

(This article belongs to the Special Issue Diabetes: Screening, Prevention, Diagnosis and Therapy)

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12 pages, 369 KiB

Open AccessReview

Preoperative HbA1c and Blood Glucose Measurements in Diabetes Mellitus before Oral Surgery and Implantology Treatments

by Dániel Végh, Bulcsú Bencze, Dorottya Banyai, Adam Vegh, Noémi Rózsa, Csaba Nagy Dobó, Zita Biczo, Gabor Kammerhofer, Marta Ujpal, Leonardo Díaz Agurto, Ignacio Pedrinaci, Juan Francisco Peña Cardelles, Gabriel Leonardo Magrin, Ninad Milind Padhye, Laura Mente, Michael Payer and Peter Hermann

Int. J. Environ. Res. Public Health 2023, 20(6), 4745; https://doi.org/10.3390/ijerph20064745 - 08 Mar 2023

Cited by 1 | Viewed by 2911

Abstract

Diabetes mellitus has become a worldwide epidemic and is frequently accompanied by a number of complications proportional to the duration of hyperglycemia. The aim of this narrative review is to assess the most up-to-date guidelines on DM provided by both diabetes and dental [...] Read more.

Diabetes mellitus has become a worldwide epidemic and is frequently accompanied by a number of complications proportional to the duration of hyperglycemia. The aim of this narrative review is to assess the most up-to-date guidelines on DM provided by both diabetes and dental associations. Furthermore, to gather evidence on the uni/bidirectional relationships of elevated HbA1c levels on dental surgery, implantology, bone augmentation, and periodontology and to demonstrate the importance of measuring HbA1c levels before invasive dental treatments. HbA1c and blood glucose measurements are a minimally invasive method for preventing complications in diabetes mellitus. The authors conducted a literature review to determine which oral conditions are affected by diabetes mellitus. MEDLINE served as a source with the use of a specific search key. Regarding oral complications of diabetes, prevention is the most vital factor. With this publication, we hope to assist physicians and dentists to make prompt diagnoses and to help in recognizing various oral manifestations of diabetes and follow the existing guidelines. Full article

(This article belongs to the Special Issue Diabetes: Screening, Prevention, Diagnosis and Therapy)

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13 pages, 543 KiB

Open AccessReview

The Causes of Insulin Resistance in Type 1 Diabetes Mellitus: Is There a Place for Quaternary Prevention?

by Marta Wolosowicz, Bartlomiej Lukaszuk and Adrian Chabowski

Int. J. Environ. Res. Public Health 2020, 17(22), 8651; https://doi.org/10.3390/ijerph17228651 - 21 Nov 2020

Cited by 27 | Viewed by 6536

Abstract

Diabetes mellitus was the first non-communicable disease that was recognized by the United Nations as a 21st-century pandemic problem. Recent scientific reports suggest that people with type 1 diabetes mellitus also develop insulin resistance, which is generally considered to be a distinctive feature [...] Read more.

Diabetes mellitus was the first non-communicable disease that was recognized by the United Nations as a 21st-century pandemic problem. Recent scientific reports suggest that people with type 1 diabetes mellitus also develop insulin resistance, which is generally considered to be a distinctive feature of type 2 diabetes mellitus. The causes of insulin resistance in type 1 diabetes mellitus were explored, but there was a lack of publications that connected the risk factors of insulin resistance in type 1 diabetes mellitus with the proposition of repair mechanisms that are offered by quaternary prevention. Toward this end, the present review is an attempt to combine the previous reports on the causes of insulin resistance in type 1 diabetes mellitus and a brief review of quaternary prevention. The destructive effect of insulin resistance on many physiological processes that predisposes the individual to chronic diabetes complications creates an urgent need to introduce effective therapeutic methods for preventing the development and progression of this pathology. Full article

(This article belongs to the Special Issue Diabetes: Screening, Prevention, Diagnosis and Therapy)

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18 pages, 798 KiB

Open AccessReview

Clinical Risk and Overall Survival in Patients with Diabetes Mellitus, Hyperglycemia and Glioblastoma Multiforme. A Review of the Current Literature

by Nicola Montemurro, Paolo Perrini and Biagio Rapone

Int. J. Environ. Res. Public Health 2020, 17(22), 8501; https://doi.org/10.3390/ijerph17228501 - 17 Nov 2020

Cited by 62 | Viewed by 3269

Abstract

The relationship between type 2 diabetes mellitus (DM2) and hyperglycemia with cancer patients remains controversial also in the setting of patients with glioblastoma multiforme (GBM), the most common and aggressive form of astrocytoma with a short overall survival (OS) and poor prognosis. A [...] Read more.

The relationship between type 2 diabetes mellitus (DM2) and hyperglycemia with cancer patients remains controversial also in the setting of patients with glioblastoma multiforme (GBM), the most common and aggressive form of astrocytoma with a short overall survival (OS) and poor prognosis. A systematic search of two databases was performed for studies published up to 19 August 2020, reporting the OS of patients with DM2 or high blood sugar level and GBM and the clinical risk of diabetic patients for development of GBM. According to PRISMA guidelines, we included a total of 20 papers reporting clinical data of patients with GBM and diabetes and/or hyperglycemia. The aim of this review was to investigate the effect of DM2, hyperglycemia and metformin on OS of patients with GBM. In addition, we evaluated the effect of these factors on the risk of development of GBM. This review supports accumulating evidence that hyperglycemia, rather than DM2, and elevated BMI are independent risk factors for poor outcome and shorter OS in patients with GBM. GBM patients with normal weight compared to obese, and diabetic patients on metformin compared to other therapies, seems to have a longer OS. Further studies are needed to understand better these associations. Full article

(This article belongs to the Special Issue Diabetes: Screening, Prevention, Diagnosis and Therapy)

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Other

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7 pages, 584 KiB

Open AccessCase Report

Early-Onset Diabetes in an Infant with a Novel Frameshift Mutation in LRBA

by Alessio Galati, Rosalia Muciaccia, Antonella Marucci, Rosa Di Paola, Claudia Menzaghi, Federica Ortolani, Alessandra Rutigliano, Arianna Rotondo, Rita Fischetto, Elvira Piccinno and Maurizio Delvecchio

Int. J. Environ. Res. Public Health 2022, 19(17), 11031; https://doi.org/10.3390/ijerph191711031 - 03 Sep 2022

Cited by 2 | Viewed by 1670

Abstract

We describe early-onset diabetes in a 6-month-old patient carrying an LRBA gene mutation. Mutations in this gene cause primary immunodeficiency with autoimmune disorders in infancy. At admission, he was in diabetic ketoacidosis, and treatment with fluid infusion rehydration and then i.v. insulin was [...] Read more.

We describe early-onset diabetes in a 6-month-old patient carrying an LRBA gene mutation. Mutations in this gene cause primary immunodeficiency with autoimmune disorders in infancy. At admission, he was in diabetic ketoacidosis, and treatment with fluid infusion rehydration and then i.v. insulin was required. He was discharged with a hybrid closed-loop system for insulin infusion and prevention of hypoglycemia (Minimed Medtronic 670G). He underwent a next-generation sequencing analysis for monogenic diabetes genes, which showed that he was compound heterozygous for two mutations in the LRBA gene. In the following months, he developed arthritis of hands and feet, chronic diarrhea, and growth failure. He underwent bone marrow transplantation with remission of diarrhea and arthritis, but not of diabetes and growth failure. The blood glucose control has always been at target (last HbA1c 6%) without any severe hypoglycemia. LRBA gene mutations are a very rare cause of autoimmune diabetes. This report describes the clinical course in a very young patient. The hybrid closed-loop system was safe and efficient in the management of blood glucose. This report describes the clinical course of diabetes in a patient with a novel LRBA gene mutation. Full article

(This article belongs to the Special Issue Diabetes: Screening, Prevention, Diagnosis and Therapy)

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