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Diabetes Elevates Levels of Systemic Inflammation

Posted on October 19th, 2009 | In Word Of Mouth

There is a connection between diabetes and oral infections such as gum disease. Periodontal disease complicate diabetic control and elevates pro-inflammatory cytokine proteins in the body. Treatment lowers these levels.

Diabetes Elevates Levels of Systemic Inflammation

Oral infections increase cytokines and complicate diabetic management.

Systemic inflammation plays an important role in the development of type 2 diabetes. Evidence points to an increased cytokine response especially the pro-inflammatory cytokines IL-1, IL-6, and TNF-alpha, the latter of which may play an important role in insulin resistance (1). Porphyromonas gingivalis, one of the microorganisms responsible for this infection, is able to invade endothelial cells and is a potent signal for monocyte and macrophage activation and the subsequent production of cytokines.

Once established in the diabetic host, chronic periodontal infections complicate diabetes control and increases the occurrence and severity of cardiovascular complications (2).

The medical literature supports the idea that treatment of chronic oral infections is essential in people with diabetes. Antimicrobial therapy significantly reduced the number of microorganisms in periodontal pockets. The results indicate that anti-microbial treatment is effective in improving metabolic control in diabetics (3).

Physicians managing diabetic conditions in their patients should consider assessment of oral infection status to be fundamental for appropriate treatment decisions.

1- Iwamoto Y, Nishimura F., The Effect of Antimicrobial Periodontal Treatment on Circulating Tumor Necrosis Factor-Alpha and Glycated Hemoglobin Level in Patients With Type 2 Diabetes. J Periodontol 2001;72:774-778. 2- Grossi SG. Treatment of Periodontal Disease and Control of Diabetes: An Assessment of the Evidence and Need for Future Research. Annals of Periodontology 2001, Vol. 6, No. 1, Pages 138-145. 3- Ibid, Iwamoto

Important Points:

  • Inflammation impacts diabetes
  • Periodontal infections create systemic inflammation
  • Antimicrobial perio treatment improves metabolic control in diabetics

Dr. David Weaver
Rivergate Dental Care
133 North Creek Blvd.
Goodlettsville, TN 37072

Phone: 888.411.SEDATE
Fax: 615.851.3535

Diabetics More Likely to have Periodontal Disease

Posted on October 19th, 2009 | In Word Of Mouth

It is important for close medical and dental management of diabetic status. People with insulin resistance are at greater risk for developing periodontal disease.

Diabetics More Likely to have Periodontal Disease

Periodontal disease is the “sixth” complication of diabetes

Gum disease is an infection condition that creates a localized area of inflammation around teeth. Diabetics are more likely to have gum disease than are non-diabetics (1). The risk is compounded for those people whose diabetes is not under control.

People with normal glucose tolerance 10 years previously, who subsequently developed impaired glucose tolerance were significantly more likely to have deep gum pockets. Research shows that the presence of gum disease is closely related to current glucose tolerance status and the development of glucose intolerance (2).

The effective treatment of gum infection is associated with a reduction in level of glycated hemoglobin (3). When chronic oral infections are successfully treated, bacterial populations in gum tissues are reduced, resulting in lowered systemic inflammation and improved metabolic control in diabetes (4).

Control of periodontal infections should thus be an important part of the overall management of diabetic patients.

1- Poorly controlled Type 2 diabetics twice as likely to develop periodontal disease. Am Acad of Perio. 2- The Severity of Periodontal Disease is Associated with the Development of Glucose Intolerance in Non-diabetics. Dent Res 83(6):485-490,2004. 3- Sara Grossi, et.al, Treatment of Periodontal Disease in Diabetics Reduces Glycated Hemoglobin. J Perio 1997;68:713-719 4- Iwamaoto Y, et.al., The Effect of Antimicrobial Periodontal Treatment on Circulating TNF-a and Glycated Hemoglobin Level in Patients With Type 2 Diabetes. J Perio 2001;72:774-778.

Important Points:

  • Diabetics have more gum disease
  • Glucose intolerance and gum disease are related
  • Perio treatment reduces HbA1c levels

Dr. David Weaver
Rivergate Dental Care
133 North Creek Blvd.
Goodlettsville, TN 37072

Phone: 888.411.SEDATE
Fax: 615.851.3535

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