Diabetes Mellitus and Periodontitis
When the body is unable to produce a hormone called insulin or cannot effectively use the Insulin it is producing. This disease is called Diabetes Mellitus
Diabetes Mellitus is of Three types, Type I, Type II, and Gestational Diabetes. In Type I Diabetes, which is also known as Insulin Dependent Diabetes, the Islets of Langerhans cannot produce Insulin. In Type II Diabetes, body produces Insulin, but body cells cannot utilize Insulin effectively. Type I diabetes usually develops in childhood or in adolescence but can also develop in adulthood. Type II Diabetes is found in adulthood. 90% of the people living with Diabetes Mellitus are Type II Diabetics. Type I Diabetics need Insulin to be injected to regulate their blood glucose. Whereas some of the Type II Diabetics can manage their blood glucose levels by healthy eating and regular exercise. In some of the cases oral medications will be required and in some extreme cases injectable Insulin is required to maintain their blood glucose level.
More than 3% of the females during pregnancy develop temporary diabetes. It is called Gestational Diabetes. Diagnosis of Gestational Diabetes puts both mother and Child at an increased risk of developing Diabetes later in life
Prediabetes is a condition where the blood glucose level is towards higher side than normal but not too high to be diagnosed as Type II Diabetes. Those who are diagnosed with Prediabetes are at the same health risks as the Diabetics are including atherosclerosis related hypertension, coronary artery disease, and stroke.
Diabetics are at an increased risk of developing Diabetic Nephropathy leading to Renal Failure, Diabetic Retinopathy which may lead to blindness, Diabetic Peripheral Neuropathy which may lead to a serious sequalae of limb amputation. Diabetics also develop atherosclerosis related Cardiovascular Problems.
In diabetics, if the blood glucose level is not controlled, wounds take longer to heal.
Apart from all these generalized complications, Diabetics are more prone to develop periodontal diseases (diseases of the supporting structures of teeth). There are many reasons including that diabetics are more prone to contract infections. Periodontal disease is considered to be a complication of diabetes.
Few studies have revealed that effective periodontal therapy can result in reduced HbA1c. Several Meta-analyses have confirmed that HbA1c reductions of around 0.4% can be anticipated following an effective periodontal therapy
Apart from other measures to control blood glucose level in diabetics, oral and periodontal health should also be promoted as a part of diabetes management. At the moment limited data supports this suggestion and a detailed large randomized controlled trial should be conducted to confirm these findings.
References:
1. Diabetes Canada: https://www.diabetes.ca/about-diabetes/what-is-diabetes
1. Diabetes Canada: https://www.diabetes.ca/managing-my-diabetes/preventing-complications/nerve-damage---amputation
3. Periodontitis and diabetes: a two-way relationship
P. M. Preshaw, A. L. Alba, D. Herrera, S. Jepsen, A. Konstantinidis, K. Makrilakis, and R. Taylor