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Objective: The aim of the present study was to assess the extent and severity of periodontal disease among type 1 diabetic patients (T1DM) and to investigate the possible association with systemic markers of glucose control and variability. Material and methods: Patients were consecutively enrolled in a Diabetic Unit. A full-mouth periodontal evaluation was performed, and data on systemic markers of diabetes were collected. Descriptive statistics and logistic and linear models were performed. Results: A total of 136 T1DM patients (mean age: 45.5 ± 14.6 years) were examined. Periodontitis was detected in 62% of cases (mean CAL: 3.0 ± 0.9 mm): stage III periodontitis was diagnosed in 32% of patients while stage IV in 8%. Mean level of glycated hemoglobin (HbA1c) was 7.5% ± 1.4. Among the investigated factors, mean CAL (p=0.040) was associated with HbA1c ≥ 7%; 93% of patients with mean CAL > 6 mm showed HbA1c ≥ 7%. Mean CAL (p=0.004), mean PPD (p=0.005), mean FMPS (p=0.030), and stage III/IV periodontitis (p=0.018) predict glucose coefficient of variation (CV). Conclusions: Periodontitis showed a relevant prevalence in the present, well-controlled T1DM population and predicts poor glycemic control (HbA1c ≥7%) and higher glucose variability. The present findings suggest that periodontal infection may have systemic effects also in T1DM patients. Clinical relevance: The extent and severity of periodontitis and its possible systemic effects in T1DM patients could be underestimated. [ABSTRACT FROM AUTHOR]

On the other hand, since diabetes is associated with a worse outcome of COVID-19 [[3]], vaccination is particularly recommended in patients with T1D. Keywords: COVID-19; Diabetes; Vaccine EN COVID-19 Diabetes Vaccine 435 438 4 02/23/22 20220301 NES 220301 Introduction In the available phase 3 trial, mRNA-1273 (Moderna) COVID-19 vaccine showed a high efficacy together with a good tolerability [[1]]. Since vaccination does not imply any relevant negative consequence on glycemic control, concerns about the effects of vaccine on glycemia should not contribute to vaccine hesitancy in people with T1D diabetes, and this is especially important for advocating clearly about the need for vaccinate all these subjects against COVID-19. [Extracted from the article]

Aims: Periodontal disease (PD) is a chronic inflammation of periodontal tissue associated with infection from specific anaerobic pathogens contained in dental plaque. Both type 1 and type 2 diabetes are associated with an increased prevalence of PDs. A two-way relationship between diabetes and periodontitis has been proposed, with diabetes increasing the risk for periodontitis, and periodontal inflammation negatively affecting glycaemic control. To date, the relationship between PD and glucose variability in type 1 diabetes has not been evaluated. To investigate the prevalence of PD in patients with type 1 diabetes and its association with glycemic control and glucose variability. Methods: In this cross-sectional study, all enrolled patients were scheduled to attend both a diabetologic and a periodontal visit. HbA1c, glucose coefficient of variation (CV), loss of clinical attachment (CAL), and periodontal probing depth (PPD) were collected. Results: 136 patients were included in the analysis. The prevalence of PD was 63%. A significant correlation was found between mean CAL and glucose CV (r = 0.31, p = 0.002), but not with HbA1c. Mean PPD was also associated with glucose CV (r = 0.27 and 0.044), but not with HbA1c. In a multiple linear regression model, with mean CAL as dependent variable, age, glucose CV, and smoking habit resulted significantly associated (r = 0.23, p = 0.013; r = 0.33, p = 0.001; r = 0.34, p < 0.001, respectively). Assuming mean PPD as dependent variable, multiple linear regression analysis showed a significant association with glucose CV and smoking habits only. Conclusions: PD is associated with glucose variability in patients with type 1 diabetes also after adjusting for the main confounders. [ABSTRACT FROM AUTHOR]

Aim: To conduct a meta‐analysis to assess the effect of continuous subcutaneous insulin infusion (CSII), continuous glucose monitoring (CGM), and the combination of the two, on glycaemic control in type 2 diabetes. Materials and methods: The analysis included randomized clinical trials comparing CSII with multiple daily injections (MDI) in people with type 2 diabetes, as well as studies comparing CGM or flash glucose monitoring (FGM) with self‐monitoring of blood glucose (SMBG), with a duration of at least 12 weeks, identified in Medline or clinicaltrials.gov. The principal endpoint was glycated haemoglobin (HbA1c) at the end of the trial. Mean and 95% confidence intervals (CIs) for HbA1c and Mantel–Haenzel odds ratios for severe hypoglycaemia were calculated, using random‐effect models. Results: The retrieved trials showed a significant heterogeneity (I2 = 90%). The difference in HbA1c between CSII and MDI was not statistically significant (−0.26% [95% CI –0.74;0.22]; P =.29). The difference in endpoint HbA1c between CGM and SMBG was marginally significant (−0.24 [95% CI –0.49;0.00]; P =.05), and CGM was possibly associated with a lower hypoglycaemic risk. Only one trial explored the effect of FGM, as compared with SMBG, on HbA1c in type 2 diabetes, finding no difference across groups (at study end: 8.4% ± 0.8% vs 8.3% ± 1.1% with FGM and SMBG, respectively). Conversely, FGM was associated with an improvement in quality of life and with a lower incidence of hypoglycaemic events. The small number of retrieved trials indicates that the results should be interpreted with caution. Conclusions: The analysis showed that CSII, CGM and FGM provide only small benefits compared with MDI (on either HbA1c, hypoglycaemic risk or quality of life) in insulin‐treated people with type 2 diabetes. [ABSTRACT FROM AUTHOR]

The article reports that despite the effectiveness of mRNA vaccines in preventing severe coronavirus disease 2019, infections occur in vaccinated individuals especially in the case of hyperglycemia. Topics include examines although COVID-19–related inflammation, even in its mild forms, could increase glycemia, glucose control during breakthrough infection in type 1 diabetes has not been studied so far.

Glucagon-like peptide-1 (GLP-1), a meal-stimulated gastrointestinal insulinotropic hormone inactivated by dipeptidyl peptidase-IV (DPP-IV), is reduced in type 2 diabetic patients. The present study shows that 2-week exposure of human glomerular endothelial cells to high glucose (22 mM) determines a highly significant increase in DPP-IV activity and mRNA expression, which cannot be entirely accounted for by hyperosmolarity. On the other hand, incubation of purified DPP-IV in a buffer solution added with high glucose does not affect enzyme activity. These results suggest that high glucose increases expression and activity of DPP-IV, possibly contributing to GLP-1 reduction in type 2 diabetic patients. [Copyright &y& Elsevier]