OBJECTIVE: This systematic review investigates whether hyperglycaemia/diabetes mellitus is associated with peri-implant diseases (peri-implant mucositis and peri-implantitis).
METHODS: Electronic and manual literature searching was conducted. An a priori case definition for peri-implantitis was used as an inclusion criterion to minimize risk of bias. The Newcastle-Ottawa Scale was used for quality assessment; random effect models were applied; and results were reported according to the PRISMA Statement.
RESULTS: Twelve studies were eligible for qualitative and seven of them for quantitative analyses. Meta-analyses detected the risk of peri-implantitis was about 50% higher in diabetes than in non-diabetes (RR = 1.46; 95% CI: 1.21-1.77 and OR = 1.89; 95% CI: 1.31-2.46; z = 5.98; p < .001). Importantly, among non-smokers, those with hyperglycaemia had 3.39-fold higher risk for peri-implantitis compared with normoglycaemia (95% CI: 1.06-10.81). Conversely, the association between diabetes and peri-implant mucositis was not statistically significant (RR = 0.92; 95% CI: 0.72-1.16 and OR = 1.06; 95% CI: 0.84-1.27; z = 1.06, p = .29).
CONCLUSIONS: Within its limits that demand great caution when interpreting its findings, this systematic review suggests that diabetes mellitus/hyperglycaemia is associated with greater risk of peri-implantitis, independently of smoking, but not with peri-implant mucositis.

BACKGROUND: It is essential to reach glycaemic control in patients with diabetes mellitus to prevent reduced life expectancy and morbidity related to complications. The aim of this study was to determine whether glycaemic control is associated with the perception of illness in type II diabetes mellitus.
METHODS: Illness perception was assessed in a sample of 242 diabetics attending a Family Health Centre in Chile using the Brief Illness Perception Questionnaire (BIPQ). We considered well-controlled individuals to have glycated haemoglobin below 7%, and we assessed association with the BIPQ score. The data were analysed by logistic regression.
RESULTS: The total BIPQ score was significantly higher (more negative perception) in non-controlled individuals; the most significant differences were found in the following dimensions: consequences (p=0.0003), personal control (p=0.0392), identity (p=0.0006) and emotional affection (p=0.018). The dimensions of timeline, treatment control, concern and coherence showed no differences between the groups. The mean age of well-controlled subjects was significantly higher than the age of non-controlled diabetics. Well-controlled patients had been diagnosed with diabetes for significantly fewer years than had those that were not.
CONCLUSIONS: Perceiving illness as more negative (BIPQ score >37) is highly associated with being a non-controlled diabetic, with more consequences over their daily life, less control over the disease and a higher number of attributable symptoms. When control variables are considered, a negative perception of diabetes has an adjusted OR of 2.14 (CI 95% 1.17-3.92) to have glycated haemoglobin above 7%.

OBJECTIVE: There are limited published data on the performance of the percentage of haemoglobin A (Hb A) as a screening test for beta thalassaemia major in the newborn period. This paper aims to analyse data derived from a national newborn bloodspot screening programme for sickle cell disease on the performance of haemoglobin A (Hb A) as a screening test for beta thalassaemia major in the newborn period.
METHODS: Newborn bloodspot sickle cell screening data from 2,288,008 babies were analysed. Data reported to the NHS Sickle Cell and Thalassaemia Screening Programme in England for the period 2005 to 2012 were also reviewed to identify any missed cases (4,599,849 babies).
RESULTS: Within the cohort of 2,288,008 births, 170 babies were identified as screen positive for beta thalassaemia major using a cut-point of 1.5% HbA. There were 51 identified through look-back methods and 119 prospectively identified from 4 screening laboratories. Among 119 babies with prospective data, 7 were lost to follow up and 15 were false positive results. Using a cut-off value of 1.5% Hb A as a percentage of the total haemoglobin as a screening test for beta thalassaemia major in the newborn provides an estimated sensitivity of 99% (from the look back arm of the study) with a positive predictive value of 87% (from the prospective arm of the study). Excluding infants born before 32 weeks gestation, the positive predictive value rose to 95%.
CONCLUSIONS: A haemoglobin A value of less than 1.5% is a reliable screening test for beta thalassaemia major in the newborn period.

OBJECTIVE: Glycosylated haemoglobin (HbA1c), a marker of diabetic glycemic control, is associated with chronic psychosocial stress in non-diabetic adults. This study aimed to determine whether HbA1c also acts as a biomarker of psychosocial stress in healthy 6-year-olds.
METHODS:
METHODS: Eligible participants were 326 children recruited from 6 socio-economically diverse areas in Melbourne, Australia, who took part in an earlier randomised trial for sleep problems at age 7 months. At 6 years, they participated in a follow-up assessment.
RESULTS:  HbA1c collected by finger-prick. Exposures (collected simultaneously): proxy measures of child stress including: (i) child mental health; (ii) maternal mental health (depression, anxiety, stress), negative life events in the preceding year, life stresses and coping; and (iii) family socioeconomic status and financial stress.
METHODS: linear regressions, adjusted for original randomisation status and clustering.
RESULTS: Sixty percent (134/225) of children retained at 6 years provided HbA1c data, which ranged from 3.9%-5.8% (SD 0.3%). No child or family variable was associated with HbA1c. Of the maternal variables, only anxiety predicted HbA1c (adjusted difference per point increase: -0.01, 95% CI: -0.003 to 0.02, P = 0.01); this association was in the opposite direction to that hypothesised and clinically insignificant.
CONCLUSIONS: HbA1c was not associated with psychosocial stress in healthy 6-year-olds. This suggests that any link between HbA1c and psychosocial stress emerges after this age, and that HbA1c is unlikely to be a reliable biomarker for stress in early childhood or over the transition to school.

BACKGROUND: Genes for thalassaemia, haemoglobin S, Glucose-6-phosphate dehydrogenase which confer resistance to malaria are found in high frequencies in Nigeria, 25% of the population being carriers of the sickle cell trait while another 25% are hemizygous for the G6PD gene. The frequency of alpha thalassaemia is equally high among Nigerians but there is little information on beta thalassaemia in this population. A recent study however suggest a high prevalence of beta thalassaemia in the same population, hence the need for this study.
METHODS: Haemoglobin A(2) and HbF were determined in healthy adults who have haemoglobin A genotype by elution after electrophoresis and alkaline denaturation methods respectively.
RESULTS: The mean HbA(2) among the subjects was 3.3% (range 2.0-5.6%) while the mean HbF was 2.6% (range 0.4-8.8%). Twenty-six percent of the subjects had HbA(2) values higher than 3.9% while 86% had HbF values greater than 1%, twenty-four percent had elevated HbA(2) and HbF. The mean HbA(2) value was 2.7% among those with HbF <1%, 3.6% among those with HbF 1-3% and 3.1% among those with HbF >3%.
CONCLUSIONS: These findings confirm that the frequency of beta thalassaemia in western Nigeria is higher than previously thought and that many of the individuals studied may be silent carriers of the beta thalassaemia trait. Its presence may also have been masked by the high prevalence of alpha thalassaemia in the same environment. It is therefore important to consider beta thalassaemia trait as a differential diagnosis in patients who present with haemolytic anaemia in this environment.