Diabetes

Diabetes is a disease in which the body does not produce insulin or insulin is not properly used by the cells, leaving the body unable to breakdown carbohydrates and starches into energy. Patients with Type 1 diabetes, representing 5-10 percent of those diagnosed with the disease, do not produce insulin.19 With Type 2 diabetes, the pancreas produces insulin, but it is either at insufficient levels or the body uses it improperly. About four percent of pregnant women experience a third type, gestational diabetes.19 Women diagnosed with this type of diabetes are at greater risk for developing Type 2 diabetes later in life.20

Figure 3: Diabetes in Women

According to the Centers for Disease Control and Prevention, diabetes is the sixth leading cause of death among women and the fourth leading cause of death among African-American, Hispanic and American Indian women.21 Nearly one-third of the 20.8 million children and adults in the United States who have diabetes do not even know they have the disease.19 Women with diabetes have three-to-four times higher risk of heart problems than women without diabetes. Deaths from heart disease in women with diabetes has increased 23 percent over the past 30 years, compared to the 13 percent decrease seen in men.22 Other complications include kidney disease, nervous system disease, dental disease, blindness and amputations.20

Risk Factors, Prevention & Treatment

One significant risk factor for diabetes is ethnicity, as African-American, Hispanic, American Indian, and Pacific/Asian Islander women are at a two-to-four times greater risk for diabetes than white females.23 Other risk factors include age (over 45), family history (parent or sibling) of diabetes, obesity, and elevated blood pressure and cholesterol. Patients who meet this profile can take steps to help prevent diabetes by controlling their weight; eating a high-fiber, lowfat diet; and increasing their physical activity. Once diagnosed, diabetes can often be controlled with little or no effect on quality of life. Type 1 diabetes is generally treated with insulin injections or an insulin pump. Hypoglycemic agents such as glipizide (Glucotrol) or glyburide (Micronase) and agents to slow digestion of carbohydrates and decrease blood glucose (metformin, Glucophage) are often prescribed for patients with Type 2 diabetes.

Oral Connections

Diabetes has been shown to be the most obvious example of a systemic disease predisposing a patient to oral infections, and consequently the infection potentially worsening the disease. Diabetes causes blood vessels to thicken, resulting in reduced circulation and a slower flow of nutrients to locations in the body where they are needed, in addition to increasing the residence time of harmful wastes in the body. This weakens the resistance of oral tissues to infection and creates longer periods of healing. A statin medication may also be recommended for patients with Type 2 diabetes, since cardiovascular disease is the primary complication of diabetes.24

Statistics illustrate the connection between diabetes and periodontal health, citing that diabetics have twice the risk of periodontal disease as non-diabetics and almost one-third of diabetics have severe periodontal disease with 5 mm or greater attachment loss.20 Oftentimes, the presence of an undiagnosed or uncontrolled diabetic might be right in front of you. Common oral symptoms include severely inflamed gingival tissues, ranging from red to magenta in color, acute gingival/periodontal abscesses (multiple and/or recurrent), rapidly advancing periodontitis, frequent fungal infections and/or xerostomia.25