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.



HUGH A. BIALECKI, D.M.D.
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