Diabetes and Periodontal Disease - Exploring the Connection
|
|
- Lilian Maxwell
- 8 years ago
- Views:
Transcription
1 Dr. Khalid Al Zoman, BDS,MSc., Diplomate, The American Board of Periodontology Head Section and Consultant, Periodontics Chairman, Saudi Board in Periodontics Department of Dentistry King Faisal Specialist Hospital and Research Centre Diabetes and Periodontal Disease - Exploring the Connection Both diabetes and periodontal disease are common chronic diseases in many parts of the world. This article describes the current evidence supporting a bi-directional relationship between diabetes and periodontal infections. Diabetes: Diabetes mellitus is a heterogeneous group of disorders with different causes but all characterized by hyperglycemia. Type 1 diabetes mellitus is due to destruction of the insulin-producing cells. Type 2 diabetes mellitus is the result of insulin resistance coupled with relative beta-cell failure (1). It is recently reported that type 2 diabetes comprises; 90% of all cases of diabetes mellitus in the population of several countries (2,3). Diabetes is now one of the most common non-communicable diseases globally. It is the fourth or fifth leading cause of death in most high-income countries and there is substantial evidence that it is epidemic in many low- and middle-income countries. Diabetes mellitus is the most common chronic endocrine disorder, affecting an estimated 5% to 10% of the adult population in industrialized Western countries, Asia, Africa, Central America and South America, and it has a large impact on society (4-6).
2 The International Diabetes Federation (IDF) has estimated the numbers of people with diabetes for 2011 of 366 million and forecasts for 2030 of 552 million (7). Saudi Arabia has one of the highest percentages of Diabetes in the world. The overall prevalence of DM in adults in Saudi Arabia is 23.7% (5).Five of the 10 countries where diabetes is most prevalent are located in the six-nation Gulf Cooperation Council, according to the International Diabetes Federation (IDF) (7). Kuwait is No. 3 while Qatar is sixth, Saudi Arabia seventh, Bahrain eighth and the United Arab Emirates No. 10. The rest of the top 10 are Pacific island nations with much smaller populations, apart from Lebanon which comes in fifth (Table1). Diabetes is characterized by an increased susceptibility to infection, poor wound healing, and increased morbidity and mortality associated with disease progression. Table 1: Top 10 countries/territories for prevalence* (%) of diabetes (20-79 years), 2011 and COUNTRY PREVALENCE (%) COUNTRY PREVALENCE (%) Kiribati Kiribati Marshall Islands Marshall Islands Kuwait Kuwait Nauru Tuvalu Lebanon Nauru Qatar Saudi Arabia Saudi Arabia Lebanon Bahrain Qatar Tuvalu Bahrain United Arab Emirates United Arab Emirates 19.8 *comparative prevalence (7) Periodontal Disease as a Complication of Diabetes Diabetes is recognized as an important risk factor for more severe and progressive periodontitis, infection or lesions resulting in the destruction of tissues and supporting bone that form the attachment around the tooth (see Figure 1). Periodontal disease has
3 been reported as the sixth complication of diabetes, along with neuropathy, nephropathy, retinopathy, and micro- and macrovascular diseases (8). Figure 1 - Diabetes is one of the most common chronic illnesses, affecting an estimated 285 million throughout the world and presents significant challenges for a wide range of health care professionals. Nowadays increasing number of reports on the bidirectional relation between diabetes and periodontal diseases makes dental professionals consider a special treatment aimed to both pathologies. Source: Taylor GW, Borgnakke WS, Graves DT. Association between periodontal disease and diabetes melitus. In: Genco RJ, Williams RC eds. Periodontal disease and overall health: a clinical guide Reproduced with permission A number of studies found a higher prevalence of periodontal disease among diabetic patients than among healthy controls (9). In a large cross-sectional study, Grossi and others (10) showed that diabetic patients were twice as likely as non-diabetic subjects to have attachment loss. Firatli (9) followed type 1 diabetic patients and healthy controls for 5 years. The people with diabetes had significantly more clinical attachment loss than controls. In another cross-sectional study, Bridges and others (11) found that diabetes affected all periodontal parameters, including bleeding scores, probing depths, loss of attachment and missing teeth. In fact, one study has shown that diabetic patients are 5 times more likely to be partially edentulous than non-diabetic subjects (12). PERIODONTAL DISEASE AND ITS EFFECTS ON GLYCEMIC CONTROL The chronic challenge of the periodontal pathogens may provide a constant source of proinflammatory cytokines that may be associated with tissue insulin resistance and poor glycemic control in subjects with diabetes (13,14). In inflamed periodontal tissues, there are increased levels of inflammatory mediators associated with tissue destruction, including tumor necrosis factor alpha (TNF-α), interleukin 6 (IL-6), interleukin 1- (IL- 1 ), prostaglandin E2, and matrix metalloproteinases (14). In addition to the local
4 destruction, this inflammation involves increased permeability of the capillaries leading to potential portals to the systemic circulation for the inflammatory mediators as well as the products of the bacterial infection (see Figure 2). Figure 2 - Increased number of neutrophils, monocytes, macrophages infiltrate the tissue to release more divert cytokines and prostaglandins that exacerbate the inflammatory response and periodontal tissue destruction. These mediators have been reported to be important in pathways for the pathogenesis of insulin resistance, coronary heart disease, and, more recently, diabetes (15). Based on this theory, it was hypothesized that the successful control of periodontal infection could improve the clinical signs of periodontitis as well as the metabolic control of DM (13). Various investigations (16-21) demonstrated that scaling and root planing (SRP), associated or not with antibiotics, yielded clinical benefits in subjects with diabetes, including a reduction in probing depth (PD), bleeding on probing (BOP), and suppuration and a gain in clinical attachment level (CAL). Simultaneously, these interventional studies (16-24) assessed the potential effects of different types of periodontal therapy on glycemic control in subjects with diabetes, as measured by glycosylated hemoglobin (HbA1c) levels. Some investigations (13,16,21-23) suggested that improvements in periodontal condition positively affect metabolic control, whereas other studies (17,24,25) did not find this beneficial effect. Al-Mubarak and colleagues (21) recently conducted a study to evaluate the effectiveness of scaling and root planing (SRP) and adjunctive chemotherapy (doxycycline hyclate, 20 mg) on gingival health and glycemic control in diabetic subjects with chronic periodontitis. Three hundred and fortysix type 1 and 2 diabetic subjects with chronic periodontitis were randomized into four test groups: Group 1 received one session of SRP at the baseline visit and placebo tablets twice/day, started at the baseline visit, for 3 months, Group 2 received one
5 session of SRP at the baseline visit, and doxycycline hyclate (20 mg, twice/day) started at the baseline visit for 3 months, Group 3 received two sessions of SRP, first at the baseline visit and second at the 6 months, with placebo tablets twice/day started at the baseline visit and 6-month visit, for 3 months at each visit, and Group 4 received two sessions of SRP, first at the baseline visit and the second at the 6-month visit, and doxycycline hyclate 20 mg twice/day, started at the baseline visit and the 6-month visit, for 3 months at each visit. Venous blood samples were obtained to evaluate glycated hemoglobin (HbA1c); dental measurements were also included. We found that HbA1c showed significant improvement (P < 0.05) only for subjects with glycated hemoglobin 8.8% within each group, as well as when subjects were combined together. All groups achieved statistically significant improvements for most of the dental parameters at follow-up visits (P < 0.05) compared to the baseline. We concluded that that SRP and adjunctive therapy may significantly reduce glycated hemoglobin levels for subjects with HbA1c 8.8%. Finally, more systematic studies in diverse populations is warranted to support existing evidence that treating periodontal infections can contribute to glycemic control management and possibly to the reduction of the burden of complications of diabetes. Recommendations 1. Health care providers should understand the effects of diabetes on periodontal tissues, the possible impact of periodontal disease in patients with diabetes and should discuss with their diabetic patients the increased risk for periodontal diseases. 2. Dentists should facilitate the identification and referral of un-recognized cases of diabetes in dental offices. They should also control oral infection in all patients with diabetes especially those with severe periodontitis so as to reduce the inflammatory burden experienced and may improve glycemic control. 3. Physicians should recognize the clinical presentations of periodontitis and consider oral inspection so that patients with diabetes who developed oral complications could be promptly referred to dentists for treatment.
6 4. Medical and dental professions should collaborate in arranging proper management of patients with diabetes in particular those with periodontitis. References: 1. Grossi SG, Genco RJ. Periodontal disease and diabetes mellitus: A two-way relationship. Ann Periodontol 1998;3: Soskolne WA, Klinger A. The relationship betweenperiodontal diseases and diabetes: An overview. Ann Periodontol 2001;6: World Health Organization. The World Health Report Reducing Risks, Promoting Healthy Life. Geneva: World Health Organization; Wild S, Roglic G, Green A, Kng H. Global prevalence of Diabetes. Estimates for the year 2000 and projections for Diabetes Care. 2004;27: Al-Nozha MM, Al-Maatouq MA, Al-Mazrou YY, Al-Harthi SS. A Diabetes mellitus in Saudi Arabia. Saudi Med J. 2004;25: Elhadd TA, Al-Amoudi AA, Alzahrani AS. Epidemiology, clinical and complications profile of diabetes in Saudi Arabia: A review. Ann Saudi Med. 2007;4: International Diabetes Federation: 8. Löe, H: Periodontal disease. The sixth complication of diabetes mellitus. Diabetes Care 16:329-34, Firatli E. The relationship between clinical periodontal status and insulin-dependent diabetes mellitus. Results after 5 years. J Periodontol 1997; 68(2): Grossi SG, Zambon JJ, Ho AW, Koch G, Dunford RG, Machtei EE, and others. Assessment of risk for periodontal disease. I. Risk indicators for attachment loss. J Periodontol 1994; 65(3): Bridges RB, Anderson JW, Saxe SR, Gregory K, Bridges SR. Periodontal status of diabetic and non-diabetic men: effects of smoking, glycemic control, and socioeconomic factors. J Periodontol 1996; 67(11): Moore PA, Weyant RJ, Mongelluzzo MB, Myers DE, Rossie K,Guggenheimer J, and others. Type 1 diabetes mellitus and oral health: assessment of tooth loss and edentulism. J Public Health Dent 1998;58(2): Grossi SG, Skrepcinski FB, DeCaro T, et al. Treatment of periodontal disease in diabetics reduces glycated hemoglobin. J Periodontol 1997;68: Lalla E. Periodontal infections and diabetes mellitus: When will the puzzle be complete? J Clin Periodontol 2007;34: Ridker PM, Wilson PW, Grundy SM. Should C-reactive protein be added to metabolic syndrome and to assessment of global cardiovascular risk? Circulation. 2004;109: Rodrigues DC, Taba MJ, Novaes AB, Souza SL, Grisi MF. Effect of non-surgical periodontal therapy on glycemic control in patients with type 2 diabetes mellitus. J Periodontol 2003;74: Promsudthi A, Pimapansri S, Deerochanawong C, Kanchanavasita W. The effect of periodontal therapy on uncontrolled type 2 diabetes mellitus in older subjects. Oral Dis 2005;11: Faria-Almeida R, Navarro A, Bascones A. Clinical and metabolic changes after conventional treatment of type 2 diabetic patients with chronic periodontitis. J Periodontol 2006;77:
7 19. Navarro-Sanchez AB, Faria-Almeida R, Bascones-Martinez A. Effect of non-surgical periodontal therapy on clinical and immunological response and glycaemic control in type 2 diabetic patients with moderate periodontitis. J Clin Periodontol 2007;34: O'Connell PA, Taba M, Nomizo A, et al. Effects of periodontal therapy on glycemic control and inflammatory markers. J Periodontol 2008;79: Al Mubarak S, Rass MA, Alsuwyed A, Al Zoman K, Al Sohail A, Sobki A et al. A new paradigm between mechanical scaling and root planing combined with adjunctive chemotherapy for glycated hemoglobin improvement in diabetics. Intern J Diabetes Mellitus 2010:2: Stewart JE, Wager KA, Friedlander AH, Zadeh HH. The effect of periodontal treatment on glycemic control in patients with type 2 diabetes mellitus. J Clin Periodontol 2001;28: Kiran M, Arpak N, Unsal E, Erdoğan MF. The effect of improved periodontal health on metabolic control in type 2 diabetes mellitus. J Clin Periodontol 2005;32: Janket SJ, Wightman A, Baird AE, Van Dyke TE, Jones JA. Does periodontal treatment improve glycemic control in diabetic patients? A meta-analysis of intervention studies. J Dent Res 2005;84: Gonçalves D, Correa FO, Khalil NM, de Faria Oliveira OM, Orrico SR. The effect of nonsurgical periodontal therapy on peroxidase activity in diabetic patients: A case-control pilot study. J Clin Periodontol 2008;35:
The Two-Way Relationship Between Diabetes and Periodontal Disease
The Two-Way Relationship Between Diabetes and Periodontal Disease This is the third in a series of research articles delivered at the RCDSO Symposium, ORAL HEALTH: A WINDOW TO SYSTEMIC DISEASE, on February
More informationDiabetes mellitus affects
Periodontal disease and diabetes A two-way street Brian L. Mealey, DDS, MS Diabetes mellitus affects an estimated 20 million Americans, about 35 to 40 percent of whom have not received a diagnosis. 1 More
More informationDoes Treatment of Oral Disease Reduce the Costs of Medical Care?
Does Treatment of Oral Disease Reduce the Costs of Medical Care? Marjorie Jeffcoat, DMD; Nipul K. Tanna, DMD, MS; Clay Hedlund, DDS; Michael S. Hahn, DDS; Miles Hall, DDS, MBA; Robert J. Genco, DDS, PhD
More informationManagement of a Patient Who Developed Uncontrolled Diabetes After Implant Placement: A Case Report
Management of a Patient Who Developed Uncontrolled Diabetes After Implant Placement: A Case Report Carpenter John F. Carpenter, DMD, MAGD 1 Abstract Background: Diabetes is a serious metabolic disorder
More informationGuidance for Industry Diabetes Mellitus Evaluating Cardiovascular Risk in New Antidiabetic Therapies to Treat Type 2 Diabetes
Guidance for Industry Diabetes Mellitus Evaluating Cardiovascular Risk in New Antidiabetic Therapies to Treat Type 2 Diabetes U.S. Department of Health and Human Services Food and Drug Administration Center
More informationHow To Determine The Prevalence Of Microalbuminuria
Research Journal of Pharmaceutical, Biological and Chemical Sciences Prevalence of Microalbuminuria in relation to HbA1c among known Type2 Diabetic Patients in Puducherry population Muraliswaran P 1 *,
More informationTYPE 2 DIABETES MELLITUS: NEW HOPE FOR PREVENTION. Robert Dobbins, M.D. Ph.D.
TYPE 2 DIABETES MELLITUS: NEW HOPE FOR PREVENTION Robert Dobbins, M.D. Ph.D. Learning Objectives Recognize current trends in the prevalence of type 2 diabetes. Learn differences between type 1 and type
More informationUsing a Flow Sheet to Improve Performance in Treatment of Elderly Patients With Type 2 Diabetes
Special Series: AAFP Award-winning Research Papers Vol. 31, No. 5 331 Using a Flow Sheet to Improve Performance in Treatment of Elderly Patients With Type 2 Diabetes Gary Ruoff, MD; Lynn S. Gray, MD, MPH
More informationDentists, diabetes and periodontitis
REVIEW Australian Dental Journal 2002;47:(3):202-207 Dentists, diabetes and periodontitis S Bjelland,* P Bray,* N Gupta,* R Hirsch Abstract This review updates the relationship between diabetes mellitus
More informationEpidemiology of Periodontal Diseases
Epidemiology of Periodontal Diseases Dania Al Agili, BDS, MS, MPH, DrPH CD 633 January 2009 Lecture Objectives 1. To know the definitions of prevalence and incidence in periodontitis. 2. To describe the
More informationAAP-Commissioned Review
AAP-Commissioned Review Diabetes Mellitus and Periodontal Diseases Brian L. Mealey* and Thomas W. Oates* Background: The purpose of this review is to provide the reader with practical knowledge concerning
More informationGlycemic Control of Type 2 Diabetes Mellitus
Bahrain Medical Bulletin, Vol. 28, No. 3, September 2006 Glycemic Control of Type 2 Diabetes Mellitus Majeda Fikree* Baderuldeen Hanafi** Zahra Ali Hussain** Emad M Masuadi*** Objective: To determine the
More informationMetabolic Syndrome Overview: Easy Living, Bitter Harvest. Sabrina Gill MD MPH FRCPC Caroline Stigant MD FRCPC BC Nephrology Days, October 2007
Metabolic Syndrome Overview: Easy Living, Bitter Harvest Sabrina Gill MD MPH FRCPC Caroline Stigant MD FRCPC BC Nephrology Days, October 2007 Evolution of Metabolic Syndrome 1923: Kylin describes clustering
More information6.4 Diabetes. 6 Priority diseases and reasons for inclusion. Background. Developments since 2004. See Background Paper 6.4 (BP6_4DM.
6 Priority diseases and reasons for inclusion 6.4 Diabetes See Background Paper 6.4 (BP6_4DM.pdf) Background Diabetes and diabetes-related illnesses place an enormous burden on the health care systems
More informationYour Life Your Health Cariodmetabolic Risk Syndrome Part VII Inflammation chronic, low-grade By James L. Holly, MD The Examiner January 25, 2007
Your Life Your Health Cariodmetabolic Risk Syndrome Part VII Inflammation chronic, low-grade By James L. Holly, MD The Examiner January 25, 2007 The cardiometabolic risk syndrome is increasingly recognized
More informationIntroduction. Pathogenesis of type 2 diabetes
Introduction Type 2 diabetes mellitus (t2dm) is the most prevalent form of diabetes worldwide. It is characterised by high fasting and high postprandial blood glucose concentrations (hyperglycemia). Chronic
More informationTuberculosis And Diabetes. Dr. hanan abuelrus Prof.of internal medicine Assiut University
Tuberculosis And Diabetes Dr. hanan abuelrus Prof.of internal medicine Assiut University TUBERCULOSIS FACTS More than 9 million people fall sick with tuberculosis (TB) every year. Over 1.5 million die
More informationTHE IMPACT OF USING BLOOD SUGAR HOME MONITORING DEVICE TO CONTROL BLOOD SUGAR LEVEL IN DIABETIC PATIENTS
THE IMPACT OF USING BLOOD SUGAR HOME MONITORING DEVICE TO CONTROL BLOOD SUGAR LEVEL IN DIABETIC PATIENTS Alshammari S., *Al-Jameel N., Al-Johani H, Al-Qahtani A., Al-Hakbani A., Khan A. and Alfaraj S.
More informationDental considerations for the patient with diabetes
Journal section: Oral Medicine and Pathology Publication Types: Review doi:10.4317/jced.3.e25 Dental considerations for the patient with diabetes Silvia Martí Álamo 1, Yolanda Jiménez Soriano 2, Mª Gracia
More informationStatins and Risk for Diabetes Mellitus. Background
Statins and Risk for Diabetes Mellitus Kevin C. Maki, PhD, FNLA Midwest Center for Metabolic & Cardiovascular Research and DePaul University, Chicago, IL 1 Background In 2012 the US Food and Drug Administration
More informationInsulin degludec (Tresiba) for the Management of Diabetes: Effectiveness, Value, and Value-Based Price Benchmarks
Background: Insulin degludec (Tresiba) for the Management of Diabetes: Effectiveness, Value, and Value-Based Price Benchmarks Final Background and Scope November 19, 2015 The Centers for Disease Control
More informationDiagnosis, classification and prevention of diabetes
Diagnosis, classification and prevention of diabetes Section 1 1 of 4 Curriculum Module II 1 Diagnosis, classification and presentation of diabetes Slide 2 of 48 Polyurea Definition of diabetes Slide 3
More informationPeriodontal Screening and Recording: Early Detection of Periodontal Diseases
Periodontal Screening and Recording: Early Detection of Periodontal Diseases Tanya Villalpando Mitchell, RDH, MS Continuing Education Units: 1 hour Online Course: www.dentalcare.com/en-us/dental-education/continuing-education/ce53/ce53.aspx
More informationDiabetes Mellitus. Melissa Meredith M.D. Diabetes Mellitus
Melissa Meredith M.D. Diabetes mellitus is a group of metabolic diseases characterized by high blood glucose resulting from defects in insulin secretion, insulin action, or both Diabetes is a chronic,
More informationDIABETES A chronic, debilitating and often deadly disease A global epidemic Diabetes in Africa
DIABETES A chronic, debilitating and often deadly disease Diabetes is a chronic condition that arises when the pancreas does not produce enough insulin, or when the body cannot effectively use the insulin
More informationDeakin Research Online
Deakin Research Online This is the published version: Cameron, Adrian J., Shaw, J.E. and Zimmet, P.Z. 2003, Diabetes, in Diabetes and kidney disease : time to act, nternational Diabetes Federation, Brussels,
More informationDiabetes Brief. Pre diabetes occurs when glucose levels are elevated in the blood, but are not as high as someone who has diabetes.
Diabetes Brief What is Diabetes? Diabetes mellitus is a disease of abnormal carbohydrate metabolism in which the level of blood glucose, or blood sugar, is above normal. The disease occurs when the body
More informationAn Interprofessional Approach to Diabetes Management
Disclosures An Interprofessional Approach to Diabetes Management Principal in DiabetesReframed, LLC. Inventor of U.S. Provisional Patent Application No. 61/585,483 METHODS OF USING A DIABETES CROSS- DISCIPLINARY
More informationIgnoring the Evidence May Be a Costly Mistake
Diabetes Mellitus and Oral Health: Ignoring the Evidence May be a Costly Mistake September 2014 Introduction Authors: Katherine Cohen, MSN, RN, PHN Conrado E. Bárzaga, MD About COH: Center for Oral Health
More informationTHE STUDY OF NEWLY DISCOVERED CASES OF DIABETES MELLITUS IN BIHOR COUNTY
Analele UniversităŃii din Oradea Fascicula:Ecotoxicologie, Zootehnie şi Tehnologii de Industrie Alimentară, 2012 THE STUDY OF NEWLY DISCOVERED CASES OF DIABETES MELLITUS IN BIHOR COUNTY *University of
More informationKnowledge of diabetes mellitus amongst nursing students Effect of an intervention
Knowledge of diabetes mellitus amongst nursing students Effect of an intervention Sukhpal Kaur, Indarjit Walia Abstract : Nurses are the key providers of diabetes care. However the information provided
More informationStatistics of Type 2 Diabetes
Statistics of Type 2 Diabetes Of the 17 million Americans with diabetes, 90 percent to 95 percent have type 2 diabetes. Of these, half are unaware they have the disease. People with type 2 diabetes often
More informationJill Malcolm, Karen Moir
Evaluation of Fife- DICE: Type 2 diabetes insulin conversion Article points 1. Fife-DICE is an insulin conversion group education programme. 2. People with greater than 7.5% on maximum oral therapy are
More informationUnderstanding diabetes Do the recent trials help?
Understanding diabetes Do the recent trials help? Dr Geoffrey Robb Consultant Physician and Diabetologist CMO RGA UK Services and Partnership Assurance AMUS 25 th March 2010 The security of experience.
More informationShutterstock TACstock
Shutterstock TACstock 10 Introduction Since 2000, the IDF Diabetes Atlas has detailed the extent of diabetes and this seventh edition shows how it is impacting every country, every age group and every
More information25-hydroxyvitamin D: from bone and mineral to general health marker
DIABETES 25 OH Vitamin D TOTAL Assay 25-hydroxyvitamin D: from bone and mineral to general health marker FOR OUTSIDE THE US AND CANADA ONLY Vitamin D Receptors Brain Heart Breast Colon Pancreas Prostate
More informationDiabetes, hypertension and a lot more `in the elderly` JORIS SCHAKEL INTERNIST- CLINICAL GERIATRICIAN JGSCHAKEL@SEHOS.CW
Diabetes, hypertension and a lot more `in the elderly` JORIS SCHAKEL INTERNIST- CLINICAL GERIATRICIAN JGSCHAKEL@SEHOS.CW IT`S HARD TO GIVE GENERAL ADVICE! ``The Elderly`` Heterogeneous group ;widely varying
More informationHealth Innovation Challenge - Chronic Disease Management. Haley Augustine & Rakesh Gupta Dalhousie University: Medical School
Haley Augustine & Rakesh Gupta 1 Health Innovation Challenge - Chronic Disease Management Haley Augustine & Rakesh Gupta Dalhousie University: Medical School Professor: Lynette Reid, lynette.reid@dal.ca
More informationTeeth and Dental Implants: When to save, and when to extract.
Teeth and Dental Implants: When to save, and when to extract. One of the most difficult decisions a restorative dentist has to make is when to refer a patient for extraction and placement of dental implants.
More informationCHAPTER V DISCUSSION. normal life provided they keep their diabetes under control. Life style modifications
CHAPTER V DISCUSSION Background Diabetes mellitus is a chronic condition but people with diabetes can lead a normal life provided they keep their diabetes under control. Life style modifications (LSM)
More informationPeriodontal (Gum) Disease: Causes, Symptoms, and Treatments
Periodontal (Gum) Disease: Causes, Symptoms, and Treatments Introduction If you have been told you have periodontal (gum) disease, you're not alone. An estimated 80 percent of American adults currently
More informationA STUDY OF MAGNESIUM SUPPLEMENTATION ON GLYCEMIC CONTROL IN PATIENTS OF TYPE-2 DIABETES MELLITUS
RESEARCH ARTICLE A STUDY OF MAGNESIUM SUPPLEMENTATION ON GLYCEMIC CONTROL IN PATIENTS OF TYPE-2 DIABETES MELLITUS Yogendra Raj Singh 1, Shilpi Verma 2, Dushyant Agrawal 3,*, Brijendra Singh 4, Ashutosh
More informationDisability Evaluation Under Social Security
Disability Evaluation Under Social Security Revised Medical Criteria for Evaluating Endocrine Disorders Effective June 7, 2011 Why a Revision? Social Security revisions reflect: SSA s adjudicative experience.
More informationOral health complications reportedly
Type 1 Diabetes Mellitus and Oral Health: Assessment of Periodontal Disease Paul A. Moore, * Robert J. Weyant, * Mary Beth Mongelluzzo, * Daniel E. Myers, Karen Rossie, James Guggenheimer, Harvey M. Block,
More informationDiabetes mellitus is a chronic condition that occurs as a result of problems with the production and/or action of insulin in the body.
International Diabetes Federation Diabetes Background Information Diabetes mellitus is a chronic condition that occurs as a result of problems with the production and/or action of insulin in the body.
More informationCOST ANALYSIS OF ANTIDIABETIC DRUGS FOR DIABETES MELLITUS OUTPATIENT IN KODYA YOGYAKARTA HOSPITAL
Malaysian Journal of Pharmaceutical Sciences, Vol. 5, No. 1, 19 23 (2007) COST ANALYSIS OF ANTIDIABETIC DRUGS FOR DIABETES MELLITUS OUTPATIENT IN KODYA YOGYAKARTA HOSPITAL TRI MURTI ANDAYANI* AND IKE IMANINGSIH
More informationCardiovascular disease physiology. Linda Lowe-Krentz Bioscience in the 21 st Century October 14, 2011
Cardiovascular disease physiology Linda Lowe-Krentz Bioscience in the 21 st Century October 14, 2011 Content Introduction The number 1 killer in America Some statistics Recommendations The disease process
More informationPowerPoint Lecture Outlines prepared by Dr. Lana Zinger, QCC CUNY. 12a. FOCUS ON Your Risk for Diabetes. Copyright 2011 Pearson Education, Inc.
PowerPoint Lecture Outlines prepared by Dr. Lana Zinger, QCC CUNY 12a FOCUS ON Your Risk for Diabetes Your Risk for Diabetes! Since 1980,Diabetes has increased by 50 %. Diabetes has increased by 70 percent
More informationOverview of Diabetes Management. By Cindy Daversa, M.S.,R.D.,C.D.E. UCI Health
Overview of Diabetes Management By Cindy Daversa, M.S.,R.D.,C.D.E. UCI Health Objectives: Describe the pathophysiology of diabetes. From a multiorgan systems viewpoint. Identify the types of diabetes.
More informationESCMID Online Lecture Library. by author
Do statins improve outcomes of patients with sepsis and pneumonia? Jordi Carratalà Department of Infectious Diseases Statins for sepsis & community-acquired pneumonia Sepsis and CAP are major healthcare
More information嘉 義 長 庚 醫 院 藥 劑 科 Speaker : 翁 玟 雯
The Clinical Efficacy and Safety of Sodium Glucose Cotransporter-2 (SGLT2) Inhibitors in Adults with Type 2 Diabetes Mellitus 嘉 義 長 庚 醫 院 藥 劑 科 Speaker : 翁 玟 雯 Diabetes Mellitus : A group of diseases characterized
More informationA multi-method pilot evaluation of an online diabetes exercise system Schaarup, Clara; Hejlesen, Ole
Aalborg Universitet A multi-method pilot evaluation of an online diabetes exercise system Schaarup, Clara; Hejlesen, Ole Published in: Digital Healthcare Empowering Europeans DOI (link to publication from
More informationDiabetes. C:\Documents and Settings\wiscs\Local Settings\Temp\Diabetes May02revised.doc Page 1 of 12
Diabetes Introduction The attached paper is adapted from the initial background paper on Diabetes presented to the Capital and Coast District Health Board Community and Public Health Advisory Committee
More informationDepression and type 2 diabetes mellitus: A case-control study in Tabuk, Saudi Arabia
Basic Research Journal of Medicine and Clinical Sciences ISSN 2315-6864 Vol. 4(11) pp. 248-252 November 2015 Available online http//www.basicresearchjournals.org Copyright 2015 Basic Research Journal Full
More informationIntegrating Medical-Dental Care Coordination for Diabetic Patients: Barriers, Solutions, and Successes
Integrating Medical-Dental Care Coordination for Diabetic Patients: Barriers, Solutions, and Successes Panel: Incorporating Oral Health into Primary Care Health Home American Association for Community
More informationPharmacology of the Respiratory Tract: COPD and Steroids
Pharmacology of the Respiratory Tract: COPD and Steroids Dr. Tillie-Louise Hackett Department of Anesthesiology, Pharmacology and Therapeutics University of British Columbia Associate Head, Centre of Heart
More informationElectronic Oral Health Risk Assessment Tools
SCDI White Paper No. 1074 Approved by ADA Council on Dental Practice May 2013 ADA SCDI White Paper No. 1074 Electronic Oral Health Risk Assessment Tools 2013 Copyright 2013 American Dental Association.
More informationPeriodontal disease (PD) is one of the most commonly known human chronic disorders.
www.scielo.br/jaos Periodontal disease and diabetes mellitus http://dx.doi.org/10.1590/1678-7757201302106 1, Olinda TARZIA 2 3 1- PhD in Medical Sciences, Research Support Center, Diabetics Association
More informationSUPPORTIVE PERIODONTAL THERAPY AND PATIENT S COMPLIANCE: AN OVERVIEW
Review Article International Journal of Dental and Health Sciences Volume 02,Issue 06 SUPPORTIVE PERIODONTAL THERAPY AND PATIENT S COMPLIANCE: AN OVERVIEW Deepak Kumar 1, Manvi Chandra agarwal 2, Ellora
More informationTERMS FOR UNDERSTANDING YOUR TYPE 2 DIABETES. Definitions for Common Terms Related to Type 2 Diabetes
TERMS FOR UNDERSTANDING YOUR TYPE 2 DIABETES Definitions for Common Terms Related to Type 2 Diabetes TYPE 2 DIABETES AND BLOOD SUGAR 1-3 This list of terms may help you beter understand type 2 diabetes,
More informationAn Essential Tool For The Care DFUs
Adjunct HBO 2 Therapy: March 16, 2016 William Tettelbach, MD, FACP, FIDSA System Medical Director of Wound & Hyperbaric Medicine Services An Essential Tool For The Care DFUs Fedorko, L., et al., Hyperbaric
More informationThe Most Common Autoimmune Disease: Rheumatoid Arthritis. Bonita S. Libman, M.D.
The Most Common Autoimmune Disease: Rheumatoid Arthritis Bonita S. Libman, M.D. Disclosures Two googled comics The Normal Immune System Network of cells and proteins that work together Goal: protect against
More informationDiabetes. Gojka Roglic. Department of Chronic Diseases and Health Promotion. World Health Organization
Diabetes Gojka Roglic What is diabetes? Diabetes mellitus is a metabolic disorder of multiple aetiology, characterized by chronic hyperglycaemia with disturbances of carbohydrate, fat and protein metabolism
More informationTreatment of diabetes In order to survive, people with type 1 diabetes must have insulin delivered by a pump or injections.
National Diabetes Statistics What is diabetes? Diabetes mellitus is a group of diseases characterized by high levels of blood glucose resulting from defects in insulin production, insulin action, or both.
More informationAÓ ÛÎfiappleËÛË ÙˆÓ appleúfiûê ÙˆÓ ÂÍÂÏ ÍˆÓ. Basic Research of periodontal diseases: A review of recent developments
BÈ ÏÈÔÁÚ ÊÈÎ AÓ ÛÎfiappleËÛË B ÛÈÎ ŒÚÂ Ó ÙˆÓ appleâúèô ÔÓÙÈÎÒÓ ÓÔÛËÌ ÙˆÓ: AÓ ÛÎfiappleËÛË ÙˆÓ appleúfiûê ÙˆÓ ÂÍÂÏ ÍˆÓ. KˆÙÛÔ ÏË * Basic Research of periodontal diseases: A review of recent developments
More informationOregon Statewide Performance Improvement Project: Diabetes Monitoring for People with Diabetes and Schizophrenia or Bipolar Disorder
Oregon Statewide Performance Improvement Project: Diabetes Monitoring for People with Diabetes and Schizophrenia or Bipolar Disorder November 14, 2013 Prepared by: Acumentra Health 1. Study Topic This
More informationObstructive sleep apnea and type 2 diabetes Obstructive Sleep Apnea (OSA) may contribute to or exacerbate type 2 diabetes for some of your patients.
Obstructive sleep apnea and type 2 diabetes Obstructive Sleep Apnea (OSA) may contribute to or exacerbate type 2 diabetes for some of your patients. Prevalence of OSA and diabetes Prevalence of OSA Five
More informationThe New Complex Patient. of Diabetes Clinical Programming
The New Complex Patient as Seen Through the Lens of Diabetes Clinical Programming 1 Valerie Garrett, M.D. Medical Director, Diabetes Center at Mission Health System Nov 6, 2014 Diabetes Health Burden High
More informationMedical Benefit Effective Date: 04/01/11 Next Review Date: 01/13 Preauthorization* Yes Review Dates: 07/07, 07/08, 07/09, 01/10, 01/11, 01/12
Continuous or Intermittent Monitoring of Glucose in Interstitial (10120) Medical Benefit Effective Date: 04/01/11 Next Review Date: 01/13 Preauthorization* Yes Review Dates: 07/07, 07/08, 07/09, 01/10,
More informationKansas Behavioral Health Risk Bulletin
Kansas Behavioral Health Risk Bulletin Kansas Department of Health and Environment November 7, 1995 Bureau of Chronic Disease and Health Promotion Vol. 1 No. 12 Diabetes Mellitus in Kansas Diabetes mellitus
More informationNutrition. Type 2 Diabetes: A Growing Challenge in the Healthcare Setting NAME OF STUDENT
1 Nutrition Type 2 Diabetes: A Growing Challenge in the Healthcare Setting NAME OF STUDENT 2 Type 2 Diabetes: A Growing Challenge in the Healthcare Setting Introduction and background of type 2 diabetes:
More informationScottish Dental Clinical Effectiveness Programme SDcep. Prevention and Treatment of Periodontal Diseases in Primary Care Guidance in Brief
Scottish Dental Clinical Effectiveness Programme SDcep Prevention and Treatment of Periodontal Diseases in Primary Care Guidance in Brief June 2014 Scottish Dental Clinical Effectiveness Programme SDcep
More informationType 1 Diabetes ( Juvenile Diabetes)
Type 1 Diabetes W ( Juvenile Diabetes) hat is Type 1 Diabetes? Type 1 diabetes, also known as juvenile-onset diabetes, is one of the three main forms of diabetes affecting millions of people worldwide.
More informationImproving drug prescription in elderly diabetic patients. FRANCESC FORMIGA Hospital Universitari de Bellvitge
Improving drug prescription in elderly diabetic patients FRANCESC FORMIGA Hospital Universitari de Bellvitge High prevalence, but also increases the incidence. The older the patients, the higher the percentages
More informationDiabetes 101. Francisco J. Prieto, M.D. American Diabetes Association National Advocacy Committee Latino Diabetes Action Council
Diabetes 101 Francisco J. Prieto, M.D. American Diabetes Association National Advocacy Committee Latino Diabetes Action Council www.diabetes.org 1-800-DIABETES www.diabetes.org 1-800-DIABETES Age-Adjusted
More informationPeriodontal Disease Risk Factors
of ysgol am Periodontal Disease Risk Factors Matthew Locke Consultant in Restorative Dentistry Cardiff University School of Dentistry Local and Systemic Risk Factors Systemic Risk factors Modifiable Specific
More informationDiabetic nephropathy is detected clinically by the presence of persistent microalbuminuria or proteinuria.
Kidney Complications Diabetic Nephropathy Diabetic nephropathy is detected clinically by the presence of persistent microalbuminuria or proteinuria. The peak incidence of nephropathy is usually 15-25 years
More informationRESTORATIVE DENTISTRY ORAL DIAGNOSIS TOOTH WHITENING/BLEACHING IMPLANT RESTORATIONS WWW.AGD.ORG. 6t952. Academy of Geucml Dentistry
RESTORATIVE DENTISTRY ORAL DIAGNOSIS TOOTH WHITENING/BLEACHING IMPLANT RESTORATIONS WWW.AGD.ORG 6t952 Academy of Geucml Dentistry 20120 II LASERS IN PERIODONTICS 1111 --------------------------------------------------------------------------------
More informationTITLE: Diabetic Diets for Frail Elderly Long-Term Care Residents with Type II Diabetes Mellitus: A Review of Guidelines
TITLE: Diabetic Diets for Frail Elderly Long-Term Care Residents with Type II Diabetes Mellitus: A Review of Guidelines DATE: 15 June 2015 CONTEXT AND POLICY ISSUES People with type 2 diabetes, also known
More informationThe Burden Of Diabetes And The Promise Of Biomedical Research
The Burden Of Diabetes And The Promise Of Biomedical Research Presented by John Anderson, MD Incoming Chair, ADA s National Advocacy Committee; Frist Clinic, Nashville, TN Type 1 Diabetes Usually diagnosed
More informationBurden of Obesity, Diabetes and Heart Disease in New Hampshire, 2013 Update
Burden of Obesity, Diabetes and Heart Disease in New Hampshire, 2013 Update Background Overweight and obesity have greatly increased among all age groups and regardless of income and education. Contributing
More informationTREATMENT REFUSAL FORMS
TREATMENT REFUSAL FORMS These forms are intended to be used when a patient refuses the treatment. These forms help confirm that the patient is informed and aware of the risks involved with not proceeding
More informationCriteria: CWQI HCS-123 (This criteria is consistent with CMS guidelines for External Infusion Insulin Pumps)
Moda Health Plan, Inc. Medical Necessity Criteria Subject: Origination Date: 05/15 Revision Date(s): 05/2015 Developed By: Medical Criteria Committee 06/24/2015 External Infusion Insulin Pumps Page 1 of
More informationConnecticut Diabetes Statistics
Connecticut Diabetes Statistics What is Diabetes? State Public Health Actions (1305, SHAPE) Grant March 2015 Page 1 of 16 Diabetes is a disease in which blood glucose levels are above normal. Blood glucose
More informationTreating Patients with PRE-DIABETES David Doriguzzi, PA-C First Valley Medical Group. Learning Objectives. Background. CAPA 2015 Annual Conference
Treating Patients with PRE-DIABETES David Doriguzzi, PA-C First Valley Medical Group Learning Objectives To accurately make the diagnosis of pre-diabetes/metabolic syndrome To understand the prevalence
More informationResidency Competency and Proficiency Statements
Residency Competency and Proficiency Statements 1. REQUEST AND RESPOND TO REQUESTS FOR CONSULTATIONS Identify needs and make referrals to appropriate health care providers for the treatment of physiologic,
More informationEffect of Methotrexate on Serum Levels of IL-1α and IL-8 in Rheumatoid Arthritis
THE RHEUMATOID IRAQI POSTGRADUATE ARTHRITIS MEDICAL JOURNAL VOL.12, NO. 3,2013 Effect of Methotrexate on Serum Levels of IL-1α and IL-8 in Rheumatoid Arthritis Ahmed A. Al-Hassan*, Mohammed O. Hamzah**,
More informationInsulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused by too little insulin, resistance to insulin, or both.
Diabetes Definition Diabetes is a chronic (lifelong) disease marked by high levels of sugar in the blood. Causes Insulin is a hormone produced by the pancreas to control blood sugar. Diabetes can be caused
More informationdental plans and term life insurance coverage
dental plans and term life insurance coverage Dental coverage Complete your Blue Shield health coverage with an affordable dental plan. Did you know that more than 90% of all common diseases have oral
More informationSecond- and Third-Line Approaches for Type 2 Diabetes Workgroup: Topic Brief
Second- and Third-Line Approaches for Type 2 Diabetes Workgroup: Topic Brief March 7, 2016 Session Objective: The objective of this workshop is to assess the value of undertaking comparative effectiveness
More informationTHE INTERNET STROKE CENTER PRESENTATIONS AND DISCUSSIONS ON STROKE MANAGEMENT
THE INTERNET STROKE CENTER PRESENTATIONS AND DISCUSSIONS ON STROKE MANAGEMENT Stroke Prevention in Atrial Fibrillation Gregory Albers, M.D. Director Stanford Stroke Center Professor of Neurology and Neurological
More informationIMPLANT CONSENT FORM WHAT ARE DENTAL IMPLANTS?
IMPLANT CONSENT FORM WHAT ARE DENTAL IMPLANTS? Dental implants are a very successful and accepted treatment option to replace lost or missing teeth. A dental implant is essentially an artificial tooth
More informationC HAPTER 4 O RAL AND M AXILLOFACIAL S URGERY
C HAPTER 4 O RAL AND M AXILLOFACIAL S URGERY I. TREATMENT PLANNING GUIDELINES As part of informed consent, the clinician should carefully explain the risks and benefits of oral and maxillofacial surgery
More informationMeasuring and Improving the Quality of Diabetes care in General Practice. Dr M Grixti. Dr C Scalpello, Dr C Mercieca, Dr P Mangion, Dr T O Sullivan
Measuring and Improving the Quality of Diabetes care in General Practice Dr M Grixti. Dr C Scalpello, Dr C Mercieca, Dr P Mangion, Dr T O Sullivan Outline of presentation Statistics Diabetes care,as the
More informationDCCT and EDIC: The Diabetes Control and Complications Trial and Follow-up Study
DCCT and EDIC: The Diabetes Control and Complications Trial and Follow-up Study National Diabetes Information Clearinghouse U.S. Department of Health and Human Services NATIONAL INSTITUTES OF HEALTH What
More informationMeasure #1 (NQF 0059): Diabetes: Hemoglobin A1c Poor Control National Quality Strategy Domain: Effective Clinical Care
Measure #1 (NQF 0059): Diabetes: Hemoglobin A1c Poor Control National Quality Strategy Domain: Effective Clinical Care 2016 PQRS OPTIONS FOR INDIVIDUAL MEASURES: CLAIMS, REGISTRY DESCRIPTION: Percentage
More informationDOES THE MOUTH PUT THE HEART AT RISK?
OBSERVATIONS HAROLD C. SLAVKIN, D.D.S. DOES THE MOUTH PUT THE HEART AT RISK? A merry heart maketh a cheerful countenance, states the Book of Proverbs, but by sorrow of the heart the spirit is broken. In
More informationOmega-3 fatty acids improve the diagnosis-related clinical outcome. Critical Care Medicine April 2006;34(4):972-9
Omega-3 fatty acids improve the diagnosis-related clinical outcome 1 Critical Care Medicine April 2006;34(4):972-9 Volume 34(4), April 2006, pp 972-979 Heller, Axel R. MD, PhD; Rössler, Susann; Litz, Rainer
More informationSemester I Dental Anatomy (Basic Orofacial Anatomy)
Dental Assisting Curriculum Example The dentalcare.com CE library offers over 150 courses that can be used in conjunction with your dental assisting curriculum. The guide below recommends courses to assign,
More informationDenominator Statement: Cardiac surgery patients with no evidence of prior infection.
Last Updated: Version 4.3b NQF-ENDORSED VOLUNTARY CONSENSUS STANDARDS FOR HOSPITAL CARE Measure Information Form CMS/The Joint Commission: Suspended (Effective immediately beginning with July 1, 2014 discharges)
More information