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Query: UMLS:C0011860 (type 2 diabetes)
 57,723 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Approximately 7% of pregnant women develop gestational diabetes mellitus (GDM), a usually transient form of diabetes mellitus, because of the production of some placental and maternal adipose tissue elaborated hormones that alter glucose metabolism. In most women the disorder resolves at delivery, but within 10 years 50% to 70% of these women go on to develop type 2 diabetes. The identification of women with past medical histories of GDM is a clinically useful marker for alerting the dentist to patients at heightened risk of occult type 2 diabetes, with a possible greater risk of developing periodontal disease and dental caries. Screening these patients for diabetes and establishing a preventative dental regimen may result in reducing the number of women with undiagnosed diabetes and diabetes-associated dental and cardiovascular diseases.
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PMID:A past medical history of gestational diabetes: its medical significance and its dental implications. 1723 28

Metabolic syndrome and type 2 diabetes (T2DM) resulting from sustained hyperglycemia are considered as risk factors for cardiovascular disease (CVD) but the mechanism for their contribution to cardiopathogenesis is not well understood. Hyperglycemia induces nonenzymatic glycation of protein-yielding advanced glycation end products (AGE), which are postulated to stimulate interleukin-6 (IL-6) expression, triggering the liver to secrete tissue necrosis factor alpha (TNF-alpha) and C-reactive protein (CRP) that contribute to CVD pathogenesis. Although the high prevalence of periodontitis among individuals with diabetes is well known by dental researchers, it is relatively unrecognized in the medical community. The expression of the same proinflammatory mediators implicated in hyperglycemia (i.e., IL-6, TNF-alpha, and CRP) have been reported to be associated with periodontal disease and increased risk for CVD. We will review published evidence related to these 2 pathways and offer a consensus.
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PMID:Oral infection, hyperglycemia, and endothelial dysfunction. 1790 6

Increasing evidence points to periodontal disease as a significant risk factor in the etiology of other diseases with inflammatory components, such as cardiovascular disease and type 2 diabetes mellitus. Thus, it may be possible to reduce the risk for other diseases with an inflammatory component by maintaining a healthy periodontium. In addition to plaque and calculus, other factors such as diet, body weight, lifestyle, and environmental stress complicate the maintenance of a healthy periodontium. It is becoming more important for the general dentist to address these additional risk factors in addition to providing conventional treatment for periodontal disease. This review addresses a multifactorial approach to the treatment of periodontal disease and suggests that the "focal theory" of infection may still be relevant for oral inflammation.
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PMID:Periodontitis as a component of hyperinflammation: treating periodontitis in obese diabetic patients. 1790 73

The prevalence of diabetes worldwide is increasing rapidly in association with the increase in obesity. Complications are a major fear of patients with diabetes. Complications of diabetes affect many tissues and organs, causing retinopathy, nephropathy, neuropathy, cardiovascular diseases, peripheral vascular diseases, stroke, and periodontal pathologies. Immunologic abnormalities are associated with type 1 and type 2 diabetes and diabetic complications. T cell abnormalities are believed to be the major cause of autoimmune disease in type 1 diabetes, leading to the destruction of pancreatic islets. In type 2 diabetes, inflammation and activation of monocytes are postulated to be important for enhancing insulin resistance and may contribute to the loss of insulin secretory function by islet cells. Many factors can enhance insulin resistance, including genetics, a sedentary lifestyle, obesity, and other conditions, such as chronic inflammation or infection. Increases in inflammation, such as activation of monocytes and increased levels of inflammatory markers, e.g., C-reactive protein, plasminogen activator inhibitor-1, and other cytokines, were reported in insulin-resistant states without diabetes. One possible mechanism is that abnormal levels of metabolites, such as lipids, fatty acids, and various cytokines from the adipose tissue, activate monocytes and increase the secretion of inflammatory cytokines, enhancing insulin resistance. According to this model, obesity activates monocytes and enhances insulin resistance, increasing the risk for type 2 diabetes. Abnormalities in innate immunity might also participate in the development of diabetic complications. In general, hyperglycemia is the main initiator of diabetic retinopathy, nephropathy, and neuropathy, and it participates in the development of diabetic cardiovascular diseases. Although the precise role of inflammation in the development of diabetic microvascular diseases is still unclear, it is likely that inflammation induced by diabetes and insulin resistance can accelerate atherosclerosis in patients with diabetes. Also, it was shown that conditions with an inflammatory basis, such as obesity and type 2 diabetes, can contribute to periodontal disease, suggesting that periodontal abnormalities may be partly influenced by inflammatory changes. Further research is required to confirm the role of inflammation and the onset of diabetes, microvascular diseases, and periodontal pathologies.
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PMID:The role of inflammatory cytokines in diabetes and its complications. 1867 7

The periodontal status of 106 type 2 diabetic patients was assessed and compared with that of 106 age-matched nondiabetics. Patients older than 20 years with type 2 diabetes mellitus were recruited from the outpatient internal medicine clinics at the 2 main hospitals in Irbid governorate, Jordan. Periodontal disease was more severe in type 2 diabetic patients than in nondiabetics, as indicated by significantly mean higher gingival index, periodontal pocket depth, clinical attachment level and tooth mobility. There was no significant difference in the mean plaque index between diabetics and nondiabetics. The severity of periodontal disease was significantly higher in patients with diabetes > 5 years than those with duration < 5 years.
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PMID:Periodontal status of type 2 diabetics compared with nondiabetics in north Jordan. 1872 Jun 30

The metabolic syndrome (also known as syndrome X, insulin resistance syndrome, dysmetabolic syndrome, deadly quartet and plurimetabolic syndrome) is a cluster of factors associated with increased risk of developing coronary heart disease and/or type 2 diabetes. Several recent studies reviewed in the present paper have indicated an association between the metabolic syndrome and periodontitis, and suggest that people exhibiting several components of metabolic syndrome should be encouraged to undergo a periodontal examination. Further investigations are required to clarify the mechanisms of the relationship between metabolic syndrome and periodontal disease in men, and to determine whether oral health care in individuals exhibiting metabolic syndrome has the potential to reduce the incidence of various systemic diseases.
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PMID:Metabolic syndrome and periodontal diseases. 1936 79

The association between periodontal disease and diabetes mellitus has been explored by many researchers over the years. Periodontal signs and symptoms are now recognized as the 'sixth complication of diabetes'. The objective of the present study was to investigate the association between glycemic control of type 2 diabetes mellitus (type 2 DM) and severity of periodontal disease. A total of 126 Saudi female patients diagnosed with type 2 Diabetes were examined. Group I (better control with Hb A1 c less than 9%) included 74 patients, and Group II (poor control with Hb A1c more than 9%) included 52 subjects. The periodontal parameters recorded were plaque index, bleeding index, presence of calculus, pocket depth measurement and clinical attachment level. These parameters were evaluated in a randomized half mouth examination on four sites of each tooth (mesial, distal, buccal and lingual). The results of this study showed that the age, duration of diabetes, percentage of plaque index and bleeding index showed no significant difference between the two groups. In contrast, there was a significantly higher percentage of calculus, PD > or = 4 mm and loss of attachment level (3-4 mm) in the poorly controlled diabetic patients, as compared to the better-controlled group. The result obtained showed a significant association of the loss of attachment level (3-4 mm) with periodontal disease in poorly controlled diabetic patients, as compared to better-controlled patients. Poor-control diabetics (group II) exhibited an increased percentage of calculus and greater risk for periodontitis.
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PMID:Evaluation of the relationship between type 2 diabetes and periodontal disease. 2061 97

Wide-ranging activation of the innate immune system causing chronic low-grade inflammation is closely involved not only in the pathogenesis of type 2 diabetes mellitus and its complications, through an ongoing cytokine-induced acute-phase response, but also in the pathogenesis of periodontal diseases, whereby cytokines play a central role in the host's response to the periodontal biofilm. Although there is extensive knowledge about the pathways through which diabetes affects periodontal status, less is known about the impact of periodontal diseases on the diabetes-related inflammatory state. This review attempts to explain the immunobiological connection between periodontal diseases and type 2 diabetes mellitus, exploring the mechanisms through which periodontal infection can contribute to the low-grade general inflammation associated with diabetes (thus aggravating insulin resistance) and discussing the impact of periodontal treatment on glycemic control in people living with both diabetes and periodontal disease.
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PMID:Impact of periodontitis on the diabetes-related inflammatory status. 2083 52

Oral health has been implicated in systemic disease throughout the ages; however, the understanding of the relationship between oral disease and systemic diseases such as cardiovascular disease and Type 2 diabetes mellitus is still emerging today. Chronic periodontal disease is widespread in the general population and a significant proportion of adults suffer from the most severe form of the disease. Dental plaque biofilm is necessary for the development of chronic periodontal disease with genetic and environmental factors contributing towards the pathogenesis. The putative biological mechanisms of the association between oral disease and atherogenesis are discussed, although there is insufficient evidence to establish causality at this time. Regardless of a direct causal relationship between oral disease and cardiovascular disease, treatment of oral disease leads to both a reduction in the systemic inflammatory burden as reflected in inflammatory markers and an improvement in endothelial function and hence improved overall health outcomes. A brief overview of periodontal disease including etiology, pathogenesis, screening and therapeutic implications is presented.
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PMID:Why should a doctor be interested in oral disease? 2093 34

There may be an interaction between periodontal disease and some systemic diseases such as diabetes mellitus. The objective of this review was to verify, by means of a review of clinical trials, if there is a positive association between periodontal disease and the glycemic control of type 2 diabetes mellitus (DM-2) patients. Eleven articles that fi t the study criteria were revised. It was concluded that periodontal disease may influence the metabolic control of DM-2. Additional studies with larger sample sizes and longer follow up are necessary for a better clarification of this issue.
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PMID:[Review on periodontal disease and metabolic control of diabetes mellitus]. 2124 88


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