Impact of COVID-19 Pandemic on Pediatric Diabetes Mellitus

The Probiotic Effects of Lactobacillus brevis CD2 on Caries Related Variables of Dental Plaque Biofilm

OBJECTIVES

This study was based on the research question: "Does L. brevis CD2 have an effect on the acidogenicity of sugar-exposed bacteria? To solve this question, a multistep study was planned: first, an in vitro investigation aimed to assess the acid production of monoculture bacterial solutions; and second, an ex vivo experiment to evaluate the production or inhibition of acids from plaque samples.

METHODS

L. brevis CD2 and several control strains (Lactobacillus brevis CD2, Lactobacillus reuteri DSM 17938, Lactobacillus rhamnosus LB21, Lactobacillus plantarum 931, Streptococcus mutans Ingbritt) were tested with various sugars; pH changes were recorded at specific time points using a micro-pH electrode. Additionally, for the ex vivo phase, the same sugars were added to equal amounts of pooled plaque from 9 healthy subjects with bacterial suspensions, as well as a control solution, and pH was monitored for up to 90 minutes. For the ex vivo phase, 9 adults were randomised in a crossover design for 28 days. For the in vivo phase, 26 healthy subjects used 1/2 lozenges 3 times daily containing either L. brevis CD2 (active) or no probiotic bacteria (placebo). Plaque acidogenicity was assessed using the microtouch method after a 10 ml mouth rinse containing 10% sucrose for 1 minute (on day 0 and day 28).

RESULTS

L. brevis CD2 exhibited the highest ability to inhibit the fermentation of fructose, lactose, and sucrose compared to the control strains (P < .05). A significant reduction in plaque acidogenicity was observed in vivo from day 0 to day 28 in the test group (P < .05).

CONCLUSIONS

This study indicates that L. brevis CD2 mitgates the acidogenic attributes of plaque biofilm organisma in vitro, in vivo and ex vivo, suggesting its potential benefit as a caries preventive probiotic agent.

Glycemic control and complications of type 2 diabetes mellitus in children and adolescents during the COVID-19 outbreak

PURPOSE

This study aimed to investigate the impact of coronavirus disease 2019 (COVID-19) on type 2 diabetes mellitus (T2DM) in children and adolescents.

METHODS

Children and adolescents diagnosed with T2DM who visited the Korea University Hospital in 2019 and 2020 were retrospectively analyzed, including changes in body mass index (BMI)-standard deviation score (SDS), glycated hemoglobin (HbA1c), diabetes complications, and diabetes management from 2019 to 2020.

RESULTS

Patient mean age and disease duration were 15.48±2.15 and 2.56±1.51 years, respectively. Obese patients accounted for 70.6% of the study population. From 2019 to 2020, mean BMI-SDS (2.21±1.25 vs. 2.35±1.43, P=0.044), HbA1c level (6.5%±2.72% vs. 7.3%±3.70%, P<0.001), blood pressure (BP), total cholesterol, and non-high-density lipoprotein cholesterol level in all patients increased significantly. Obesity was an independent predictor of increased HbA1c (95% confidence interval, 1.071-50.384; P=0.042). HbA1c levels did not increase significantly in nonobese patients, whereas HbA1c (6.45%±2.30% vs. 7.20%±3.05%, P<0.001), BMI-SDS (2.88±0.75 vs. 3.08±0.98, P=0.045), diastolic BP (P=0.037), and total cholesterol values (P=0.019) increased in obese patients in 2020 compared to 2019.

CONCLUSION

During the COVID-19 outbreak, glycemic control and diabetic complications worsened in children and adolescents with T2DM, particularly in obese patients. Close monitoring for glycemic control and diabetic complications is necessary in children and adolescents with T2DM, especially those with obesity.