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| about periodontal disease |
| In this column, we will reply to questions about periodontal disease, monthly. We hope you can learn correctly what periodontal disease in connection with your health is, and refer to it for your life. |
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| The 6th The basic knowledge
of gum disease |
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Q2:Is
it true that periodontitis exacerbates
diabetes?
A2:
When there is inflammation somewhere in
the body, it may affect adversely on the
condition of diabetes.There are two types
of diabetes: type 1 and type 2. Type 1
diabetes occurs in patients who have no
insulin secretion at pancreas while type
2 diabetes occurs in patients who have
insulin secretion but have little sensitivity
to insulin itself. The state is called
insulin resistance. Since periodontitis
are inflammatory diseases, they affect
adversely on both types of diabetes.
Mechanism of insulin resistance
In good health condition, pancreas releases
insulin as blood-sugar level increases,
and take sugar into fat cells, skeletal
muscles, and hepatic cells. With this
action of insulin, cells build up energy
and blood glucose level of the body is
kept constant. However, when diabetes
is developed, fat cells generate inflammatory
cytokines and lower the function of insulin.
As the result, blood glucose level is
affected and loses its constancy (insulin
resistance). This is one of the reasons
how inflammation exacerbates diabetes.
In the advanced stage of periodontitis,
inflammatory cytokines are generated from
the lesion. When these inflammatory cytokines
enter into blood stream through capillary
vessels in mouth, insulin resistance of
the body will be advanced and exacerbate
the symptoms of diabetes.On the other
hand, when oral condition is improved
with the treatment of periodontal diseases,
substances that inhibit the function of
insulin will be decreased and diabetic
symptoms will also be reduced.
For some time now studies have revealed
that diabetes induce or accelerate periodontal
diseases. This mechanism had been explained
as a result of suppressed immune system.
However, recent study explains further:
insulin resistance occurs when number
of advanced glycation end products (AGEs)
is increased in the body of diabetic patients,
they stimulate immune cells such as neutrophiles
and macrophages to generate cytokines
and exploit vascular walls. In another
words, generated cytokines advance the
inflammation of periodontal diseases.
Consequently, periodontal diseases are
called sixth common complication of diabetes,
following nephropathy (renal impairment),
retinopathy (decreased vision), nervous
disease, large arteries disorder, and
smaller vessels disorder.
Photograph offer: Okayama University
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