diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM13495diaendo-13495Research ArticleОБЗОРЫREVIEWSЗаболевания пародонта у пациентов с сахарным диабетом 1 типа: патогенетические и клинические аспектыPeriodontal Diseases in Patients with Type 1 Diabetes Mellitus: Pathogenetic and Clinical Aspectshttps://orcid.org/0000-0002-4457-7261ХагабановаИ. С.KhagabanovaI. S.

Хагабанова Илона Сафраиловна, аспирант 

117292, г. Москва, ул. Дмитрия Ульянова, д. 11 

Ilona S. Khagabanova, MD, PhD student

 

khagabanova2000@mail.ruhttps://orcid.org/0000-0003-1868-2727СтародубоваА. В.StarodubovaA. V.

Стародубова Анна Владимировна, к.м.н.

Москва

Anna V. Starodubova, MD, PhD

Moscow

anna.sta@mail.ruhttps://orcid.org/0000-0002-4242-7059СелифановаЕ. И.SelifanovaE. I.

Селифанова Елена Ивановна, д.м.н.

Москва

Elena I. Selifanova, MD, PhD

Moscow

selifana@mail.ruhttps://orcid.org/0000-0002-3433-0142ШамхаловаМ. Ш.ShamkhalovaM. S.

Шамхалова Минара Шамхаловна, д.м.н.

Москва

Minara S. Shamkhalova, MD, PhD

Moscow

shamkhalova@mail.ruhttps://orcid.org/0000-0002-9717-9742МокрышеваН. Г.MokryshevaN. G.

Мокрышева Наталья Георгиевна, д.м.н., профессор, академик РАН 

Москва

Natalya G. Mokrysheva, MD, PhD, Professor, Academician of the RAS

Moscow

nm70@mail.ruГНЦ РФ ФГБУ «Национальный медицинский исследовательский центр эндокринологии имени академика И.И. Дедова»РоссияEndocrinology research centreRussian Federation202601102026294386392Copyright © Хагабанова И.С., Стародубова А.В., Селифанова Е.И., Шамхалова М.Ш., Мокрышева Н.Г., 20262026Хагабанова И.С., Стародубова А.В., Селифанова Е.И., Шамхалова М.Ш., Мокрышева Н.Г.Khagabanova I.S., Starodubova A.V., Selifanova E.I., Shamkhalova M.S., Mokrysheva N.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.dia-endojournals.ru/jour/article/view/13495ВВЕДЕНИЕ

ВВЕДЕНИЕ: Заболевания пародонта при сахарном диабете 1 типа (СД1) представляют собой мультифакторную клинико-патогенетическую проблему, обусловленную нарушениями углеводного обмена, иммунного ответа и микроциркуляции. Несмотря на достижения современной медицины, вопросы своевременной диагностики и оптимизации терапии заболеваний пародонта при СД1 имеют высокую клиническую и научную значимость.

ЦЕЛЬ

ЦЕЛЬ: Систематизировать современные данные о патогенетических и клинических аспектах, обусловливающих двунаправленную связь между СД1 и заболеваниями пародонта.

МАТЕРИАЛЫ И МЕТОДЫ

МАТЕРИАЛЫ И МЕТОДЫ: Проведен анализ научных публикаций за последние 20 лет из баз данных PubMed, Scopus и Google Scholar с использованием ключевых терминов: «сахарный диабет 1 типа», «заболевания пародонта при сахарном диабете 1 типа», «пародонтит», «двунаправленная связь».

ОСНОВНЫЕ РЕЗУЛЬТАТЫ

ОСНОВНЫЕ РЕЗУЛЬТАТЫ: Современные данные подтверждают наличие двунаправленной связи между СД1 и заболеваниями пародонта. Хроническая гипергликемия способствует развитию и прогрессированию пародонтита за счет изменений орального микробиома, активации AGEs-RAGE-сигнального пути, микрососудистых нарушений, дисфункции нейтрофилов и нарушения репаративных процессов. В то же время хроническое воспаление пародонта усиливает системное воспаление и ассоциировано с ухудшением гликемического контроля. Проанализированные данные подчеркивают многофакторность патогенеза заболеваний пародонта при СД1 и обосновывают необходимость междисциплинарного подхода и ранней диагностики.

ЗАКЛЮЧЕНИЕ

ЗАКЛЮЧЕНИЕ: Совершенствование методов ранней диагностики и внедрение междисциплинарных, персонализированных подходов к ведению пациентов с СД1 и заболеваниями пародонта позволят улучшить клинические исходы. Перспективным направлением является разработка и валидация комплексных клинико-лабораторных алгоритмов оценки риска и прогноза стоматологических осложнений при СД1.

INTRODUCTION

INTRODUCTION: Periodontal diseases in patients with type 1 diabetes mellitus (T1DM) represent a multifactorial clinicopathogenetic problem, driven by disturbances in carbohydrate metabolism, immune response, and microcirculation. Despite advances in modern medicine, timely diagnosis and optimization of therapy for periodontal diseases in T1DM remain of high clinical and scientific significance.

OBJECTIVE

OBJECTIVE: To systematize current data on pathogenetic and clinical aspects underlying the bidirectional relationship between T1DM and periodontal diseases.

MATERIALS AND METHODS

MATERIALS AND METHODS: We analyzed scientific publications from the past 20 years in PubMed, Scopus, and Google Scholar using key terms: “type 1 diabetes mellitus”, “periodontal diseases in type 1 diabetes”, “periodontitis”, and “bidirectional relationship”.

KEY FINDINGS

KEY FINDINGS: Current evidence confirms the presence of a bidirectional relationship between T1DM and periodontal diseases. Chronic hyperglycemia contributes to the development and progression of periodontitis through alterations in the oral microbiome, activation of the AGEs–RAGE signaling pathway, microvascular dysfunction, neutrophil impairment, and defective reparative processes. Conversely, chronic periodontal inflammation exacerbates systemic inflammation and is associated with worsened glycemic control. These findings highlight the multifactorial pathogenesis of periodontal diseases in T1DM and underscore the need for an interdisciplinary approach and early diagnosis.

CONCLUSION

CONCLUSION: Improvement of early diagnostic methods and implementation of interdisciplinary, personalized management strategies for patients with T1DM and periodontal diseases may enhance clinical outcomes. A promising direction is the development and validation of integrated clinical–laboratory algorithms for risk assessment and prognosis of dental complications in T1DM.

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The authors declare that there are no conflicts of interest present.