Urinary myo-inositol levels in Japanese schoolchildren with normal glucose tolerance

Imbalance of Myoinositol and D-Chiro-Inositol in Saliva of Children With Type-1 Diabetes Mellitus: A Cross-Sectional Study

OBJECTIVE

Earlier work suggests Myoinositol (MI) and D-chiro- inositol (DCI) imbalance in urine and plasma of diabetic patients, and their potential for monitoring insulin resistance. This study aimed to assess levels of Myoinositol (MI) and D-chiro- inositol (DCI) in saliva of children with type 1 diabetes mellitus (DM-1) and controls, to verify if concentrations of MI and DCI are similarly altered in saliva, exploring their potential for monitoring DM-1.

DESIGN, PATIENTS AND MEASUREMENTS

This cross-sectional clinical study enroled 45 patients (DM-1, n = 25; Controls, n = 20). Children aged 3-12 years with fasting blood glucose levels > 126 mg/dL, and HbA1c levels > 7%. Saliva was collected, and salivary measurements included pH, flow rates and concentrations of MI, DCI and glucose, employing high-performance liquid chromatography. Periodontal health was assessed using bleeding and plaque indices.

RESULTS

Children with DM-1 showed elevated MI (p = 0.001), reduced DCI (p = 0.001), and increased MI-DCI ratio (p = 0.001). The MI-DCI ratio was elevated by 16-fold among diabetic children. Plaque (p = 0.003) and gingival bleeding (p = 0.001) were higher in DM-1 than controls. The MI increased the odds of an outcome of DM-1 by 174%, while DCI reduced the odds by 63%, highlighting their strong and opposing effects on DM-1.

CONCLUSIONS

Children with DM-1 express higher MI and lower DCI levels, while non-diabetic children show an inversion of these concentrations. Inositol imbalance in saliva of diabetic children resembles previous results in urine, and represents a possible venue for monitoring this disease, paving the way for future investigations into salivary inositols.

Characteristics of individuals who developed type 2 diabetes from prediabetes despite undergoing interventions, and evaluation of the performance of urinary myo-inositol as a risk factor for developing diabetes

AIMS/INTRODUCTION

The aim of this study was to clarify the characteristics of individuals with prediabetes who developed type 2 diabetes despite undergoing interventions, and to evaluate the performance of urinary myo-inositol (UMI) as a noninvasive indicator for the risk of developing diabetes.

MATERIALS AND METHODS

A total of 51 individuals with prediabetes who underwent a 75-g oral glucose tolerance test, ΔUMI (the difference in the UMI : creatinine ratio between before and 120 min after 75-g glucose loading), fasting plasma glucose, insulin, hemoglobin A1c, noninvasive testing (age, body mass index, blood pressure) and general blood tests were measured at baseline, and underwent dietary/exercise guidance for 8 years were studied.

RESULTS

A total of 31 participants developed diabetes in 8 years. At baseline, the group that developed diabetes was characterized by high ΔUMI, hemoglobin A1c, fasting plasma glucose and low high-density lipoprotein cholesterol, and insulinogenic index (I.I.). I.I and ΔUMI showed a higher correlation than fasting plasma glucose and hemoglobin A1c. Regarding diabetes onset within 8 years, Cox regression analysis of diabetes onset showed the baseline ΔUMI is an independent predictor, adjusted for the result of not only noninvasive markers, but also that of noninvasive and general blood markers. The log-rank test showed that all glycemic indicators were significantly associated with diabetes onset.

CONCLUSION

Participants who developed type 2 diabetes from prediabetes despite undergoing interventions were characterized by high glycemic control markers and low I.I. As noninvasive measurement of ΔUMI is associated with I.I. and diabetes onset, it could be a useful indicator for identifying individuals with a high risk of diabetes onset.