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
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伤口世界,是倡导远程、就近和居家管理慢性伤口的连接、整合和拓展线上和线下资源的平台生态圈。解决了伤口专家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、低成本管理慢性伤口的问题。
自成立以来,教育一直是伤口世界的主要关注领域之一。改善伤口管理和伤口护理教育是实现协会改善和发展伤口管理的主要目标的重要因素。 教育活动由教育委员会协调。
在这里可以找到有关伤口治疗的国际指南,国际伤口护理教育和协会出版物的更多信息。
伤口世界为希望了解慢性伤口/溃疡的原因和管理的患者与私人护理人员提供信息。
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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