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Periodontal Disease and Diabetes
Mellitus
Diabetes mellitus, or diabetes as it is
commonly called, is a disease in which unusually high levels
of sugar are found in the blood due to the body's inadequate
utilization of insulin - a hormone manufactured in the pancreas
to produce energy. There are two forms of diabetes: Type 1 and
Type 2. People with Type 1 diabetes produce little or no insulin,
and those with Type 2 diabetes produce normal or slightly above
average amounts of insulin, but the body has grown resistant
to its effects, resulting in an insulin shortage.
The link between periodontal disease and
diabetes has been well-documented. Studies have found periodontal
disease to be more prevalent in diabetics versus non-diabetics.
This is probably due to the fact that diabetics are more susceptible
to contracting infections. In fact, diabetics lose more teeth
than non-diabetics.
Now however, researchers are also finding that periodontal disease
may predispose or exacerbate the diabetic condition. In a randomized,
controlled trial, periodontal treatment in diabetics showed a
reduction in the need for insulin following periodontal treatment
of two separate groups of diabetic patients. (1,2) A longitudinal
study of diabetes and periodontal disease found that severe periodontitis
may be an important risk factor for the progression of diabetes
and physicians should consider the periodontal status of diabetes
patients having difficulty with glycemic control. (3)
The prevalence of diabetes has increased by 75 percent over the
past 35 years. According to the Centers for Disease Control,
nearly 16 million Americans, 5.9 percent of the population, live
with the disease, and 5.4 million are unaware they have the illness.
As with the many infection-related complications of diabetes,
gum disease is intrinsically linked to poor metabolic control.
For more information on the link between
periodontal disease and diabetes, please refer to the following
Annals ofPeriodontology (July 1998) research articles:
- Soskolne WA. The epidemiological and clinical
aspects of periodontal disease in diabetics.
Annals of'Periodontology 1998;3:2-12.
- Lalla E, Lamster IB, Schmidt AM. Advanced
interaction ofglycation end products with their cellular receptor
RAGE: implications for the pathogenesis of accelerated periodontal
disease in diabetes.
Annals ofPeriodontology 1998 ;3:13-19.
- Nishimura F, Takahashi K, Kurihara M, Takashiba
S, Murayama, Y. Periodontal disease as a complication of
diabetes mellitus. Annals ofPeriodontology 1998;3:20-29.
- Taylor G, Burt BA, Genco, RJ, Becker, MP,
Genco R, Shiossman M. Glycemic control and alveolar bone loss
in
type 2 diabetes. Annals ofPeriodontology 1998,3:30-39.
- Salvi GE, Beck JD, Offenbacher S. PGE, IL-lp,
and TNFa responses in diabetics as modifiers of periodontal
disease expression. Annals ofPeriodontology l998;3:40-50.
- Grossi SG, Genco RJ. Periodontal disease
and diabetes mellitus: a two-way relationship.
Annals ofPeriodontology 1998;3:51-61.
Sources:
1 Williams RC, Mahan CJ. Periodontal disease and diabetes in
young adults. JAMA 1960; 172:776-778.
2 Miller LS, Manwell MA, Newbold D, et al. The relationship between
reduction in periodontal inflammation and
diabetes control: a report of 9 cases. JPeriodontol 1992;63:843-849.
3 Knowier WC, Pettit DJ, Saad MF, Bennett PH. Diabetes mellitus
in the Pima Indians: incidence, risk factors and
pathogenesis. Diabetes Metab Rev 1990;6:l-27.
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HUGH A. BIALECKI, D.M.D.
P.O. Box 275, Blue Jay, California 92317
Phone: 909.337.0705 - Fax: 909.337.4925 |
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