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.