Pathogenesis of Diabetes and Periodontal Health–a Two-way Connection
Journal Title: Journal of Pharmaceutical and Biomedical Sciences - Year 2016, Vol 6, Issue 10
Abstract
Periodontitis has been traditionally regarded as a chronic inflammatory oral infection. However, recent studies indicate that this oral disease may have profound effects on systemic health. Periodontitis is an infection that is twice as prevalent in diabetic individuals compared to non-diabetics. Porphyromonas gingivalis, one of the microorganisms responsible for this infection, is able to invade endothelial cells and is a potent signal for monocyte and macrophage activation. Thus, once established in the diabetic host, this chronic infection complicates diabetes control and increases the occurrence and severity of microvascular and macrovascular complications. Persistent elevation of IL-1 beta, IL-6, and TNF-alpha in the diabetic state have an effect on the liver, stimulate the release of acute-phase proteins, produce the characteristic dysregulation of lipid metabolism associated with type 2 diabetes, and have effects on pancreatic beta cells as well. In addition, TNF-alpha, a potent inhibitor of the tyrosine kinase activity of the insulin receptor, has been implicated as an etiologic factor for insulin resistance. Collectively, the evidence supports a role for cytokine elevation in the pathophysiology and metabolic abnormalities associated with diabetes. It has been reported that for every person known to have diabetes, there are many individuals in whom the disease remains undiagnosed. It means that dentists will regularly encounter diabetic patients in their clinic. This review emphasizes the possible role of diabetes on the periodontal health of the patient and the ways in which untreated periodontitis may influence the course of diabetes.
Authors and Affiliations
Mitul Kumar Mishra, Anand Rajderkar, Priyanka Kadoo, Ranjeet Bapat
Keywords
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