RT @TheBDA: A new poll of 4000 children found half saw unhealthy food and drink products from either businesses or influencers on social me….

Anatomical/embryological thought for the day . The appendix is an outpouching of the tube of the gut. So are the lung airways!. And upstream of the whole gut tube is . The mouth!. (Other gut outpouchings downstream of the mouth are available).#NotJustACakeHole.

Join millions who have switched to Grok.

We need a new word for being content and frustrated in equal measure. What's your vote?.

The vagus nerve doesn’t supply the gastrointestinal tract, just a bit of it. And there are two of them, not one. And they are left handed (left anterior to right) . And the mouth is still more important than this gut-brain axis nonsense. #oralgutbrainaxis.

Thought for the day . You don't eat with your gut, you eat with your mouth. The gut is downstream from your mouth. The health of your gut (and gut microbiome) depends on the health of your mouth (and oral microbiome). Stop studying the gut as if the mouth doesn't exist.

Thought for the day…. Remember that you are a #holobiont - a superorganism made up of you (the human bit) and the trillions of microbes which are essential to your normal biological function. What are you feeding your oral microbiome and gut microbiome today?.

Thank you for reading. Now . -Stop eating sugar and other non-evolutionary junk.-Stop smoking/vaping.-Get your gums sorted (bleeding is always abnormal).-Take oral health seriously.-Keep your teeth. Because your mouth is precious and #NOTJUSTACAKEHOLE.

19/19.This is a thread only about diabetes. The same gum disease bacteria are also directly implicated in biological mechanisms of causality in . -Atherosclerosis.-Neurodegeneration.-Autoimmunity.-Cancers.-Lung disease.-Gut disease.-Pregnancy complications.

18/19.In summary, the bacteria of gum disease aren't limited to causing chronic inflammation/cell damage in the gums. They translocate and do the same everywhere in the body. If anyone has a better biological explanation for causation of insulin resistance, please let me know.

17/19.At autopsy, 40% of people dying with diabetes have P.gingivalis in their pancreas (and this is just one of 774 bacteria in the human oral microbiome).

16/19.The Ilievski et al study was performed in mice and humans. The presence of P.gingivalis in pancreatic islet cells corresponded with cells becoming 'bihormonal', producing both insulin and glucagon. The implications for the endocrine function of the pancreas is clear.

15/19.This paper (Ilievski et al.) shows that pancreatic islet cells infected with P.ginigvalis (the main bacterium species of gum disease) no longer produce insulin efficiently. Instead they become 'bihormonal' - producing both insulin and glucagon. (So the pancreas is screwed!).

14/19.Ilievski et al 2020.Identification of a periodontal pathogen and bihormonal cells in pancreatic islets of humans and a mouse model of periodontitis.

13/19.For more detail on mechanisms, here is what happens when P.gingivalis (to name just one of the potential gum disease bacteria culprits) does when it reaches the human pancreas and infects islet cells - the cells which produce insulin. .

12/19.Here's another nice summary of mechanisms . Su et al 2022.Periodontitis as a promoting factor of T2D: current evidence and mechanisms.And a nice illustration (read the legend).

11/19.Liu et al 2024.Gingipain from Porphyromonas gingivalis causes insulin resistance by degrading insulin receptors through direct proteolytic effects. Please note the use of the C-word in the title. It means the bacteria of gum disease CAUSE diabetes!

Thouvenot et al. 2022.Links between Insulin Resistance and Periodontal Bacteria: Insights on Molecular Players and Therapeutic Potential of Polyphenols. (Specifically note the role of P.gingivalis, the keystone pathogen of gum disease) . 10/19

9/19. and wherever they go in the body they cause the same chronic inflammatory processes, just in different parts of the body that are not the mouth, including the pancreas and insulin sensitive organs. Here is some suggested reading for those interested . .

8/19.For those (like me) interested in biological mechanisms of disease, here is a selection of introductory papers to the concept of vascular translocation of gum disease bacteria. In summary, when your gums are inflamed, the bacteria causing the inflammation escape the mouth. .

7/19.If you want an intro to concepts relating to the bidirectional relationship between diabetes and gum disease, try reading . Barutta et al 2022.Novel Insight into the Mechanisms of the Bidirectional Relationship between Diabetes and Periodontitis.