Chee, Park, and Bartold (2013) conducted a study to identify the association between periodontitis and diabetes basing on the past studies that suggested the existence of a bidirectional relationship between these two conditions. The study utilized secondary data, using the databases of MEDLINE and EMBASE to obtain the literature. In the findings on how diabetes becomes a risk factor for the causation of periodontitis, the study revealed that poor glycaemic control raises the chances of periodontitis. The adverse consequences of improper glycaemic control among the patients with diabetes led to the severity of periodontitis.
Additionally, the study outlined some of the ways that diabetes affects the periodontal health, which included the role of adipokines and inflammation. Chee, Park and Bartold (2013) assert that there is a relationship between obesity and diabetes. Obesity causes chronic inflammation and the resistance of insulin, a features of type II diabetes. As a result of the insulin resistance, periodontitis chances increase. Also, the insulin resistance raises the markers of inflammation. Adipokines like adiponectin, therefore, play a role in reducing insulin resistance through enhancing the insulin action in the liver and reducing the glucose levels in the blood.
Chee, Park, and Bartold (2013) also identify the role of Neutrophils in the inflammations by stating that they undergo spontaneous apoptosis within a day. However, delays occur if neutrophils get exposed to bacterial lipopolysaccharide, leading to the destruction of tissues and creating high chances of periodontitis. Defective polymorph-nuclear is high among diabetic patients. Chee, Park, and Bartold (2013) also observed that after the resorption of bones by the osteoclasts, their repair through bone formation occurs in a process called coupling. However, in diabetic patients, the coupling is significantly reduced, causing loss of bones.
Chee, Park, and Bartold (2013) further noted that periodontitis is a risk factor for diabetes as there is a 50% chance of patients with periodontitis suffering from diabetes. However, the study pointed out that there is no significant evidence of an association between periodontitis and the complications of diabetes and its mortality.
#2
Kıran et al. (2005) also conducted a study to identify the effects that improving the periodontal health had on the metabolic control among the type II diabetes patients. The study employed primary data, making use of 44 respondents who were all type II diabetes patients and randomly assigned the subjects. Some of the information obtained from the respondents included their brushing habits, their denture use, smoking information, missing teeth and their diabetes duration.
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The investigation found out that there is significant evidence suggesting that diabetes can cause periodontitis as well as that periodontal infection also negatively influencing glycaemic control. Despite this result, Kıran et al. (2005) also observed that not all the investigations reported that periodontal treatment led to glycaemic control.
Kıran et al. (2005) suggested that for patients with type II diabetes, their infection rates are high. The association between periodontitis and diabetes indicates how the latter exposes people to oral diseases. After the establishment of the infection, it exacerbates the systemic illness. The study also found out that the prevalence of periodontal disease among the type II diabetes patients who have inadequate control of their condition is higher compared to those without the condition.
Kıran et al. (2005) assert that the diabetic condition damages the gingival fibroblast synthesis of glycosaminoglycan and collagen. It also boosts the collagenolytic activity of crevicular fluid, causes loss of alveolar supporting bone and periodontal fibers. Finally, it loosens and eventually exfoliates the teeth. The changes that diabetes induces in the immune functions of the cells lead to inflammatory immune cell phenotypes that result in chronic inflammation, the breakdown of tissues and low repair rates of tissues. Kıran et al. (2005) further observed that still, it is unclear if controlling periodontal infections may improve the metabolic diabetes control.
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Chee, B., Park, B., & Bartold, P. M. (2013). Periodontitis and type II diabetes: a two‐way relationship. International Journal of Evidence‐Based Healthcare, 11(4), 317-329.
Kıran, M., Arpak, N., Ünsal, E., & Erdoğan, M. F. (2005). The effect of improved periodontal health on metabolic control in type 2 diabetes mellitus. Journal of Clinical Periodontology, 32(3), 266-272.