Thanh T. Nguyen1,2 · Miguel Bandeira3 · Catherine Giannopoulou3 · Alkisti Zekeridou3 · Dongryeol Ryu1 · Karim Gariani4,5
Received: 10 September 2025 / Accepted: 6 January 2026 © The Author(s) 2026
Abstract
Periodontitis is a chronic inflammatory disease affecting the tooth-supporting structures, and its closely linked to diabetes mellitus through a well-established bidirectional relationship. Diabetes exacerbates periodontal destruction via systemic inflammation, oxidative stress, and immune dysfunction, while periodontitis can impair glycemic control by increasing systemic inflammatory burden. The pathogenesis of periodontitis remains only partially understood, involving microbial dysbiosis, host immune responses, and metabolic disturbances. The 2018 classification system defines stages and grades based on disease severity and progression risk. Epidemiological data reveal a high global prevalence, particularly among individuals with type 2 diabetes. Studies have shown that periodontal therapy contributes to improved glycemic control and may reduce cardiovascular risk. Despite its clinical significance, periodontitis remains underdiagnosed in the context of diabetic care. Effective management requires integrated medical and dental collaboration, targeting both glycemic regulation and periodontal health. This dual approach offers mutual benefits for reducing complications and improving long-term outcomes in diabetic patients. In this review, we present the current knowledge on the relationship between diabetes and periodontitis, focusing on epidemiology, pathogenesis, and management.
Keywords Diabetes · Periodontitis · Oral health · Oral inflammation · Cardiovascular
Communicated by Annunziata Lapolla.
Karim Gariani
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1 Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, Republic of Korea
2 Center of Endocrinology, Metabolism, Genetic/Genomics and Molecular Therapy, Vietnam National Children’s Hospital, Hanoi, Vietnam
3 Division of Regenerative Dental Medicine and Periodontology, University Clinics of Dental Medicine, University of Geneva, Geneva, Switzerland
4 Division of Endocrinology, Diabetes and Metabolism, Department of Medical Specialties, Geneva University Hospitals, Geneva 1205, Switzerland
5 Faculty Diabetes Center, University of Geneva Medical Center, University of Geneva, Geneva, Switzerland
Claudio Maffeis1 · Ilaria Fierri1 · Elisa Morotti1 · Erika Caiazza1 · Quincy Pedranzini1 · Marco Marigliano1 · Claudia Piona1
Received: 20 October 2025 / Accepted: 6 January 2026 / Published online: 31 January 2026 © The Author(s) 2026
Aims To investigate the relationship between body adiposity and glycemic control in children and adolescents with type 1 diabetes (T1D).
Methods This cross-sectional study included 364 children and adolescents aged 6–18 years with T1D. Anthropometric indi-ces [BMI, BMI Z-score, waist-to-height ratio (WHtR)] and body composition [fat mass (FM), FM%, fat mass index (FMI)], assessed using bioelectrical impedance analysis, were obtained. Hemoglobin A1c and glucose sensor metrics, including time in range (TIR), were used to assess glycemic control. Associations between variables were analyzed using Spearman’s correlation. Logistic regression models were run to identify independent predictors of HbA1c<7.0% and TIR>70%, with FMI, WHtR, total daily insulin dose per kg (TDD), treatment modalities, sex, age, diabetes duration, and pubertal stage as independent variables.
Results Adiposity measures (FMI, FM%, and WHtR) were positively associated with HbA1c and negatively with TIR in both sexes. Logistic regression showed that HbA1c<7% and TIR>70% were significantly predicted by FMI [OR(95%CI): 0.822(0.704–0.960), p=0.013, and 0.807(0.681–0.955), p=0.012, respectively] and WHtR(x100) [OR(95%CI): 0.927(0.874– 0.983), p=0.013, and 0.923(0.866–0.985), p=0.015, respectively], independently of TDD, sex, treatment modalities and the other independent variables.
Conclusions Body adiposity negatively impacts glycemic control in children and adolescents with T1D, independent of sex and insulin treatment modalities. Despite technological advances in diabetes care, excess adiposity is emerging as a key modifiable factor associated with poorer glycemic outcomes and, consequently, poorer long-term health in children and adolescents with T1D.
Keywords Type 1 diabetes · Children · Body mass index · Adiposity · HbA1c · TIR
Abbreviations
ADA American Diabetes Association
AID Automated insulin delivery
BMI Body mass index
BP blood pressure
CGM Continuous glucose monitoring
Communicated by Annunziata Lapolla
Marco Marigliano
1 Section of Pediatric Diabetes and Metabolism, Department of Surgery, Dentistry, Pediatrics, and Gynecology, University and Azienda Ospedaliera Universitaria Integrata of Verona, Piazzale Stefani, 1, Verona 37126, Italy
CVRFs Cardiovascular risk factors
FM Fat mass
FMI Fat mass index
GRI Glycemia risk index
HDL High-density lipoprotein cholesterol
IP Insulin Pump
ISPAD International Society for Pediatric and Adoles
cent Diabetes
LDL Low-density lipoprotein
MDI Multiple daily injection
PwD People with type 1 diabetes
TAR Time above range
TBR Time below range
TDD Total daily dose/kg of body weight
TG Triglycerides (TG)
TIR Time in range
T1D Type 1 diabetes
WC Waist circumference
WHtR Waist-to-height ratio
原创: 十六点五 中山二院糖尿病足中心
随着糖尿病患病人数的不断增加,糖尿病足的病人也越来越多,在平时的临床实践中,笔者发现很多糖尿病足病友搞不清楚糖尿病足应该由什么科管?或者说哪个科的医师负责糖尿病足的诊断和治疗。
控制血糖是预防糖尿病足最重要的措施之一,也是治疗糖尿病足综合治疗的基础之一。当出现严重的并发症糖尿病足的时候,控制血糖最重要的方法目前一般认为是胰岛素治疗,而且最好是胰岛素的强化治疗。但很多患者不是非常理解,往往产生很多问题,对于其中一些有代表性的问题做一些回答。
原创:十六点五 中山二院糖尿病足中心
有不少医护人员为了糖尿病足病患者殚精竭虑地工作着,但是也有很多人不理解这种工作的意义,认为糖尿病足患者如果尽快截肢(踝关节以上),可以省去很多医疗资源和社会资源的投入,而且目前各种支具的生产越来越精巧、越来越智能、也越来越便宜,这种劳神费力的工作真有意义吗?
底压力的改变是糖尿病足发病最重要的因素,一般认为这些足底压力的变化是由于糖尿病神经病变所致,而神经病变的极致就是夏柯氏关节的形成。
伤口世界平台生态圈,以“关爱人间所有伤口患者”为愿景,连接、整合和拓展线上和线下的管理慢性伤口的资源,倡导远程、就近和居家管理慢性伤口,解决伤口专家的碎片化时间的价值创造、诊疗经验的裂变复制、和患者的就近、居家和低成本管理慢性伤口的问题。
2019广东省医疗行业协会伤口管理分会年会
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