SATURDAY, June 7 (HealthDay News) -- People with type 2 diabetes
can help control the disease by taking better care of their teeth
and gums.
That's the case dentists were expected to make at the American
Diabetes Association's annual meeting in San Francisco this
weekend.
"Several recent studies have shown that having periodontal
disease makes those with type 2 diabetes more likely to develop
worsened glycemic control, and puts them at much greater risk of
end-stage kidney disease and death," George W. Taylor, an associate
professor of dentistry at the University of Michigan schools of
Dentistry and Public Health, said in a prepared statement. "Given
the numerous medical studies showing that good glycemic control
results in reduced development and progression of diabetes
complications, we believe there is the potential that periodontal
treatment can provide an increment in diabetes control and
subsequently a reduction in the risk for diabetes complications,"
he said.
Intensive periodontitis intervention, for example, can
significantly lower one's levels of A1C, a measure of long-term
glucose control.
"We have found evidence that the severity of periodontal disease
is associated with higher levels of insulin resistance, often a
precursor of type 2 diabetes, as well as with higher levels of
A1C," dentist Maria E. Ryan, director of clinical research at the
Stony Brook University School of Dental Medicine in New York, said
in a prepared statement.
Periodontal, or gum, disease is an infection and chronic
inflammatory disease of the tissues surrounding and supporting the
teeth. As it is painless, most people don't know they have it, yet
it is a major cause of tooth loss in adults.
Among the studies to be discussed linking gum disease and
diabetes are:
- A 1988-1994 U.S. population data study that found having
periodontal disease put a person at twice the risk of having
insulin resistance as those without such disease.
- An unpublished Stony Brook University study of people
displaying pre-diabetic insulin resistance that links the severity
of a periodontal disease with their degree of insulin resistance.
"We think periodontitis may adversely affect glycemic control,
because the pro-inflammatory chemicals produced by the infection --
such as IL-1 beta, IL-6 and TNF-alpha -- could transfer from the
gum tissue into the bloodstream and stimulate cells to become
resistant to insulin," Taylor said. "Then insulin resistance
prevents cells in the body from removing glucose from the
bloodstream for energy production."
- A set of studies of the Pima Indians in the Southwest, a
population with a very high rate of type 2 diabetes. One found
those with periodontitis were more than four times as likely to
develop worsened glycemic control; another showed that those with
severe gum disease had more than triple the risk of dying from
diabetic nephropathy or ischemic heart disease than those with less
severe periodontal disease.
- A study, funded by the National Institutes of Health, that
found a "statistically significant reduction" in A1C levels in
people with type 2 diabetes after 15 months after routine
periodontal treatment, Taylor said.
"When glycemia has been difficult to control, the physician
might consider asking patients when they last saw their dentist,
whether periodontitis has been diagnosed and, if so, whether
treatment has been completed," Ryan said. "A consultation with the
dentist may be appropriate, to discuss whether periodontal
treatment has been successful or whether a more intensive approach
with oral or sub-antimicrobial antibiotics is in order because,
just as it is difficult to control diabetes while the patient has
an infected leg ulcer, the same applies when there's infection and
inflammation of the gums."
More information
The American Academy of Periodontology has more about
gum
disease.
