Living with diabetes is already challenging enough, and it comes with depression. Scientists say people with diabetes are up to twice as likely to experience depressive symptoms compared to those without it. But a new study suggests that controlling inflammation in the body could help treat depression in diabetics. However, the best approach depends on the type of diabetes you have.

The Two Types

Type 1 and type 2 diabetes are not the same. The latter is mostly known for the body’s inability to manage blood sugar effectively. In type 1 diabetes, on the other hand, the immune system attacks the insulin-producing cells in the pancreas, leaving the body without its natural blood sugar control.

Researchers have long known that both types can affect mental health. But this new work, published in the journal Diabetologia, suggests that the kind of inflammation happening in your body could hold the key to finding the most effective treatment for depression.

Diabetes and depression often form a harmful feedback loop. High blood sugar can trigger fatigue and brain fog, depression can lead to poor self-care, and the cycle rolls on. Add inflammation to the mix, a biological response that can affect brain chemistry, and it becomes even harder to break free from the spiral.

The Study

The researchers from the Research Institute of the Diabetes Academy Mergentheim (FIDAM) in Germany decided to explore exactly how inflammation affects the success of depression treatments in people with diabetes. They measured 76 different inflammatory markers in the blood of 521 participants with type 1 or type 2 diabetes, all of whom were being monitored for depressive symptoms over a year.

Behavioural Therapy Works But Not the Same for Everyone

One of the main treatments tested was cognitive behavioural therapy (CBT), a structured form of psychotherapy that focuses on changing unhelpful thought patterns.

For people with type 2 diabetes and high inflammation levels, CBT worked wonders, reducing symptoms like joylessness and helping patients shift towards more positive thinking.

But for those with type 1 diabetes and similarly high inflammation levels, CBT didn’t have the same magic. Improvements were smaller, especially for symptoms like fatigue, trouble sleeping, or loss of appetite. This suggests that the underlying biology, in this case, the type of inflammation, plays a huge role in determining whether a therapy hits the mark.

Why the Difference?

The researchers believe it comes down to the nature of the inflammation. In type 2 diabetes, inflammation is largely metabolic, a consequence of the body’s inability to handle blood sugar properly. In type 1 diabetes, the inflammation is autoimmune; the immune system itself is attacking parts of the body.

These two processes likely influence the brain and mood in different ways, which might explain why CBT was a better fit for type 2 diabetics, while type 1 diabetics with high inflammation could benefit more from treatments aimed at reducing inflammation directly, such as anti-inflammatory drugs.

The Numbers Don’t Lie

The data revealed an intriguing split. In people with type 2 diabetes, higher levels of 26 biomarkers were linked to bigger improvements in depression symptoms after CBT. In type 1 diabetes, higher levels of 13 biomarkers were actually linked to smaller improvements.

This is more than a curious statistic; it could be the basis for personalised mental health care in diabetes. Instead of trying the same approach for everyone, doctors might one day test inflammation markers first, then choose the right therapy based on each patient’s biological profile.

Why This Matters

For diabetics, depression isn’t just an emotional burden; it can directly affect physical health. Low mood can make it harder to stick to a treatment plan, exercise, or eat well. Addressing both conditions at once could lead to better long-term health outcomes.

As study author Norbert Hermanns says, people with type 2 diabetes and high inflammation levels possibly respond particularly well to a change in depressive cognitions through cognitive behavioural therapy. People with type 1 diabetes and high inflammation levels, on the other hand, could benefit more from anti-inflammatory drug therapies.

The right combination of physical and mental health treatments could help patients feel better faster.

The Future of Tailored Treatments

The idea of personalised medicine is gaining traction in all areas of healthcare, and this research shows why. In the future, doctors could run a simple blood test, see which inflammatory markers are elevated, and then decide whether a patient might do best with therapy, medication, or both.

For millions of children and teenagers, migraine isn’t just “a bad headache.” It’s a debilitating neurological condition that can disrupt school performance, social life, and emotional well-being. Now, for the first time, there’s a preventive treatment specifically approved for younger patients — and it comes in the form of a single-dose injection called Ajovy.

The U.S. Food and Drug Administration (FDA) approved Ajovy (fremanezumab-vfrm) for use in the preventive treatment of episodic migraine in youth and adolescents between 6 and 17 years old, with a weight of at least 45 kg (99 lbs). This approval adds to Ajovy's current use in adults and makes it the first and sole calcitonin gene-related peptide (CGRP) antagonist approved for pediatric prevention of migraine.

As 1 in 10 U.S. children and teens suffer from migraine, the approval helps fill an urgent need. Pediatric migraine too often is underrecognized and undertreated, but its consequences can be severe — resulting in absenteeism from school, poor performance in school, and social isolation.

Challenges of pediatric migraines are different. Children cannot always describe their symptoms or attribute them to precipitating factors like adults can. Parents usually endure a long, frustrating process of trial and error before developing an effective treatment for their child. Up until now, no FDA-approved medications targeting CGRP for migraine prevention were available to children.

Dr. Jennifer McVige, a neurologist with the DENT Neurologic Institute in Buffalo, New York, describes the approval as "an important step forward" to assist clinicians with this "often-overlooked condition" using a specific approach that can decrease frequency in younger patients.

How Ajovy Works for Migraine Prevention?

Migraines are partially fueled by calcitonin gene-related peptide (CGRP) — a neuropeptide that is involved in pain transmission and inflammation in the nervous system. Ajovy is a monoclonal antibody that binds to CGRP so that it cannot bind to receptors on the body's cells. This stops the chain reaction that results in migraine pain.

By blocking CGRP activity, Ajovy is able to decrease migraine days by 1.5 to 2 days on average per month in responsive patients. Some may see improvement in the first week, and most will respond within the first month.

Ajovy's configuration makes it extremely suitable for active families. It comes in two forms: a prefilled injection device or a single-dose syringe. It may be administered monthly or every three months (quarterly).

The shots are subcutaneous, administered in the abdomen, thigh, or upper arm. Patients, parents, or guardians can learn to give the shot at home — less often to the clinic and making it simpler for kids to stay on therapy.

Will This Medicine Help to Treat The Invisible Disability in Children?

Though it strikes millions, pediatric migraine is invisible to too many. Symptoms extend beyond pain:

• Nausea and vomiting
• Sensitivity to light and noise
• Fatigue and concentration problems

These symptoms have the potential to derail a child's schooling and social life. Chris Fox, Head of Global Marketing for Teva Pharmaceuticals, said this approval "fills an unmet gap in care" and offers families new options to manage the challenges of the condition.

Ajovy's approval arrives on the heels of new research investigating other migraine prevention possibilities for adolescents. At the American Academy of Neurology's 77th Annual Meeting, scientists revealed initial results on zonisamide — a seizure drug — that indicated it might decrease migraine days in children and adolescents. Though promising, the findings are preliminary and don't yet show cause-and-effect.

This highlights the significance of having a well-studied, FDA-approved option such as Ajovy, which has been intensively tested for safety and efficacy in pediatric patients.

What Parents Need to Know About Pediatric Migraine?

For a child missing school days by the month with migraine, each attack prevented is an opportunity to remain in class, play with classmates, or participate in after-school activities free from fear of pain. For parents, controlling pediatric migraine is about more than pills. Lifestyle changes, including:

• Establishing regular sleep routines
• Drinking plenty of fluids
• Cutting back on evening screen time
• Learning stress-reducing activities, such as yoga or mindfulness

These measures can be supplemented by Ajovy's preventive action. With a long-acting treatment, families will have less need to be in emergency mode all the time and can concentrate on these supportive measures instead.

Ajovy's home dosing regimen also decreases the medical disruption of a child's routine, facilitating improved adherence and minimizing the treatment burden. This may result in fewer migraines, but also a smoother course through school and social milestones.

Tennis great Monica Seles, in an interview with Associated News, recently shared that she was diagnosed with myasthenia gravis (MG) three years ago. This is the first time she's spoken publicly about the disease, which is a rare condition that causes muscles to become weak.

Seles, who won nine major tennis titles, first noticed something was wrong while hitting tennis balls. She said she started seeing two balls instead of one and felt a sudden weakness in her arms and legs. She also mentioned that simple things like blowing out her hair became very difficult.

Seles said it was hard for her to accept the diagnosis at first. She decided to speak out to help others, hoping her story will bring more attention to myasthenia gravis. Before she got her diagnosis, she had never heard of the condition.

What Is Myasthenia Gravis?

Medscape explains that myasthenia gravis is a chronic neuromuscular disease. This means it's a long-term illness that affects the way your nerves and muscles work together. It causes weakness in the muscles that you can control, such as those in your arms, legs, and face. While it can affect people of any age, it is most common in:

• Young women under 40
• Older men over 60

Symptoms of Myasthenia Gravis

The most common symptoms of MG are:

• Visual problems which includes drooping eyelids and seeing double.
• Your muscles might feel weak and tired very quickly, and this can change from day to day or even hour to hour.
• Your facial muscles can become weak, which may make a smile look more like a snarl.
• Difficulty speaking or swallowing, you might also have trouble pronouncing words or swallowing food.
• Weakness in the neck or limbs like your arms, legs, or neck may feel weak

The symptoms of MG can sometimes look like other conditions, so it's always important to see a doctor for a proper diagnosis. People with MG may experience periods when their symptoms get worse (flare-ups) and periods when they get better (remission), but the condition is rarely cured completely.

How is Myasthenia Gravis Diagnosed?

To figure out if you have MG, your doctor will ask about your symptoms and medical history. One key way they test for it is by giving you a specific medicine. If your muscle weakness quickly gets a lot better after taking the medicine, it's a strong sign that you have MG.

Doctors might also use other tests. They can do blood tests to look for certain antibodies that are common in people with MG. They might also use nerve and muscle tests to see how your nerves are sending signals to your muscles and to measure your muscle's electrical activity.

Treatment and Management of Myasthenia Gravis

While there's no cure for MG, the symptoms can be controlled. The main goal of treatment is to make your muscles stronger and prevent problems with breathing and swallowing. Most people with MG can live normal or close-to-normal lives with the right care.

Treatment often includes medicine, such as drugs that control the immune system or help your muscles work better. Sometimes, a doctor may suggest surgery to remove the thymus gland, which can help reduce symptoms for many people. Other treatments, like plasmapheresis, can be used to remove the bad antibodies from your blood.

Can You Prevent Myasthenia Gravis?

To help prevent a myasthenia crisis, you should always take your medicines exactly as prescribed. It can also help to take your medicine 30 to 45 minutes before meals to prevent food from getting into your lungs.

Try to avoid getting sick by staying away from people with colds or the flu, and make sure you get proper nutrition, rest, and manage your stress. It is also very important to always tell your doctors about your MG diagnosis and the medicines you are taking before they prescribe you anything new. Some medicines can interfere with your condition or your treatment.

The most serious complication of MG is a myasthenia crisis. This is when you have extreme muscle weakness, especially in the muscles you need to breathe. This is a medical emergency and may require help from a breathing machine.

Seles, who is 51, said she has learned to live with a "new normal." She sees this challenge as just another "reset" in her life, similar to when she moved to the U.S. as a young teenager or when she was recovering from a stabbing. Her message is one of strength and a reminder to always adjust, just like a tennis player on the court.

For decades, getting vaccinated has meant rolling up your sleeve, bracing for a quick jab, and hoping the soreness fades within a day. But a team of researchers may have just discovered a way to sidestep the needle entirely — by delivering vaccines through something as ordinary as dental floss.

The idea sounds almost too simple: coat floss or a floss pick with a vaccine, thread it between your teeth, and let your gums do the rest. But the science behind it is far from gimmicky. This novel approach targets a unique spot in the mouth called the junctional epithelium, an unusually permeable layer of tissue where the gums meet the teeth. And according to early research, this entry point could unlock stronger protection against respiratory infections — and for some people, make getting vaccinated a far less stressful experience.

Most viruses that wreak havoc on the body, including influenza and COVID-19, first invade through the mucosal surfaces of the mouth, nose, or lungs. Traditional injectable vaccines do an excellent job of generating antibodies in the bloodstream, but they’re less effective at producing antibodies along these mucosal barriers — the body’s first defense line.

Dr. Harvinder Singh Gill, a professor in nanomedicine at North Carolina State University and senior author of the study, explains the advantage: “When a vaccine is given via a mucosal surface, antibodies are stimulated not only in the bloodstream but also on mucosal surfaces. This improves the body’s ability to prevent infection, because there’s an additional line of defense before a pathogen even enters the body.”

That’s where the junctional epithelium comes in. Unlike most epithelial layers that are tightly sealed to keep invaders out, the JE is intentionally “leaky” so immune cells can patrol and defend against the constant barrage of oral bacteria. This leakiness is exactly what makes it an appealing vaccine delivery route.

To test the concept, researchers applied a peptide-based flu vaccine to unwaxed dental floss, then used it to floss the teeth of lab mice. The results were striking. The floss-based delivery triggered far higher antibody responses on mucosal surfaces than the current gold-standard oral method — placing a vaccine under the tongue.

In fact, the immune protection was comparable to delivering the same vaccine through the nasal cavity, which is widely considered the most effective mucosal route. The big difference? Nasal vaccination comes with safety concerns, including the rare but serious possibility that the vaccine could migrate to the brain. The floss technique avoids that risk entirely.

Lead author Rohan Ingrole, who conducted the research during his doctoral studies at Texas Tech University, adds that the method also worked across multiple vaccine types — including protein-based vaccines, inactivated viruses, and mRNA formulations. In each case, the floss delivery triggered robust immune responses both in the bloodstream and across mucosal surfaces.

What Is the Junctional Epithelium?

The JE sits deep in the gum pocket, where it forms a protective seal between the tooth and surrounding gum tissue. Its structure lacks many of the tight junctions found in other mucosal linings, making it easier for molecules — including vaccine antigens — to cross. And because it’s already brimming with immune cells, any antigen that slips through is quickly flagged, sparking an immune reaction.

Delivering a vaccine here isn’t straightforward. The tissue is tucked away and can’t be reached with a simple swab or spray. Dental floss, however, is designed to slip into exactly that space — which is why it’s the perfect vehicle for the job.

Flossing Vaccine Shows Success In Early Human Trials

While full-scale human vaccine trials are still a way off, the researchers ran a smaller test to confirm whether people could successfully target the junctional epithelium using floss picks. They coated floss with fluorescent food dye and asked 27 volunteers to try to deposit the dye into their gum pockets. The results were encouraging: about 60% of the dye ended up exactly where it needed to be.

This success suggests that with the right design, floss picks could be a practical, self-administered vaccine delivery tool — potentially mailed to people’s homes in the future.

Needle-free vaccination is more than just a comfort perk. Globally, needle phobia is a significant barrier to vaccine uptake, even among adults. There’s also the risk of unsafe injection practices, which can transmit blood-borne diseases in settings without strict medical oversight.

A floss-based vaccine could address several of these challenges. It’s simple to administer, doesn’t require a healthcare professional, and could be distributed more easily in hard-to-reach areas. Storage and transport could also be simplified compared to injectable vaccines that require strict cold-chain logistics.

Dr. Gill notes another advantage: eating and drinking immediately after floss-based vaccination doesn’t appear to interfere with the immune response — at least in animal models. That flexibility could make it easier for people to incorporate vaccination into daily routines without major disruptions.

Are There Any Limitations to Such Vaccines?

Despite the promise, this approach isn’t without drawbacks. It wouldn’t work for infants or toddlers without teeth, and it may be less effective for people with gum disease or severe oral infections. Researchers also need to study how different oral health conditions could influence vaccine uptake and immune response.

For now, the team’s next step is to refine the delivery system and begin clinical safety trials. If successful, floss-based vaccines could become an alternative option for seasonal flu shots, pandemic preparedness, and even certain routine immunizations.

The floss vaccine fits into a growing push to move beyond injections. Researchers have explored dissolvable microneedle patches, inhalable vaccines, and even edible vaccine capsules. Each approach aims to make vaccination less invasive, easier to distribute, and more acceptable to populations hesitant about traditional methods.

In this case, the innovation comes from using a tool that people already know and can use on their own. The fact that it could also boost mucosal immunity something standard injections struggle to do — makes it even more compelling.

We’re still years away from picking up a vaccine-coated floss pick at the pharmacy, but the groundwork is being laid. If clinical trials confirm its safety and effectiveness, floss-based vaccination could offer a new, accessible, and needle-free way to protect against some of the world’s most common and dangerous infections.