Diabetes Res Clin Pract. 2025 May 8;224:112234. doi: 10.1016/j.diabres.2025.112234. Online ahead of print.
ABSTRACT
BACKGROUND: Periodontitis can lead to the development of atherosclerotic heart disease.
AIM: To assess the relation between periodontal disease and continuous glucose monitoring (CGM)-derived metrics, caspase-3 and carotid intima media thickness (CIMT) in adolescents with type 1 diabetes mellitus (T1DM).
METHODS: This cross-sectional study included 115 participants with T1DM (15.91 ± 2.14 years). CIMT, CGM-derived metrics, periodontal probing depths (PPD) and amount of loss clinical attachment (CAL) were assessed. Serum caspase-3 levels were measured in T1DM participants compared with 40 healthy controls.
RESULTS: Periodontitis was found in 69.6 % of T1DM group. Serum caspase-3 levels were significantly elevated in T1DM participants compared with controls (median 8.4 versus 1.2 ng/mL; p < 0.001. Participants with periodontitis had higher percentage of nephropathy with elevated CIMT, caspase-3 levels, glucose management indicator (GMI) (7.5 ± 0.58 versus 7.1 ± 0.51 %; p = 0.047), coefficient of variation (CV) (36.4 ± 5.6 versus 33.2 ± 5.9 %; p = 0.008) and glycemic risk index while time in range (TIR) was significantly lower (58.5 ± 14.1 versus 69.7 ± 11.5 %; p = 0.002) compared with those without periodontitis. Participants using advanced hybrid close loop system had lower caspase 3 levels and CIMT compared with those on multiple daily injections. There were positive correlations between caspase-3 and GMI (r = 0.587), CV (r = 0.434), CIMT (r = 0.425), PPD (r = 0.952) and CAL (r = 0.739) while caspase-3 was negatively correlated to TIR(r = -0.481; p < 0.001 for all).
CONCLUSION: Periodontitis is prevalent among adolescents with T1DM and is linked to glycemic variability and poor metabolic control while associated with diabetic nephropathy and subclinical atherosclerosis. Elevated caspase-3 highlights the involvement of apoptosis in periodontal disease and subclinical atherosclerosis in T1DM.
PMID:40339704 | DOI:10.1016/j.diabres.2025.112234