Title: Oral Manifestations in Type 2 Diabetes Mellitus and Its Association with Diabetic Complications
Authors: Dr Noorul Ameen, Dr Udayashankar, Dr Baghya Madhivanan, Prof. Rajasekaran
DOI: http://dx.doi.org/10.18535/jmscr/v4i10.26
Background: Diabetes Mellitus is a metabolic disorder characterised by hyperglycemia due to reduced insulin secretion or insulin sensitivity. The incidence of this disease is increasing worldwide. The onus is on early diagnosis and early identification of diabetic complications. Oral cavity examination may provide clues to the presence of these complications. Aim: To find out the prevalence of oral manifestations in diabetes mellitus patients and to analyze the relationship between the oral manifestations and complications of diabetes mellitus. Study design: Prospective study from April 2014 to December 2014 Material and Methods: All diabetic patients attending the medicine OP during the study period were included after obtaining their consent. These patients were subjected to complete dental examination and evaluated for end organ damage. i.e. diabetic nephropathy, retinopathy and ischemic heart disease. Results: During the study period, a total of 101 diabetic patients were examined for oral manifestations such as periodontitis, dental caries, glossitis and oral submucosal fibrosis. Oral manifestations were present in more than 90% of all the diabetic patients. The prevalence of periodontitis was 55.4%, dental caries - 46.5%, Xerostomia - 5.9%, Glossitis - 9.9%, Oral submucosal fibrosis - 4%. Of the 101 patients, 55 of them were screened for ischemic heart disease and 19 of them had coronary artery disease (p value -0. 001). In addition 89 patients were evaluated for renal complications and 58 patients had diabetic nephropathy (p value- 0.001).Further 39 patients were evaluated for diabetic retinopathy out of which 14 had fundal changes suggestive of retinopathy ( p value – 0.001). Also all the three complications were associated more with periodontitis. Conclusion: The complications of diabetes are life threatening if not detected early. Oral examination in a diabetic patient can be a diagnostic clue to these complications. Especially, presence of periodontitis can suggest the presence of complications like nephropathy, retinopathy and ischemic heart disease in diabetic patients. Keywords: Diabetes Mellitus, periodontitis, diabetic retinopathy , diabetic nephropathy. 1. Sasisekhar TVD, Alekhya Y, Jagadeesh CH , Sudha A , Diabetic complications leading to mortality IJRRMS 2012;2(3) 2. Yingfeng Zheng, Mingguang He, and Nathan Congdon , The worldwide epidemic of diabetic retinopathy Indian J Ophthalmol. 2012 Sep-Oct; 60(5): 428–431 3. V. Mohan, S. Sandeep, R. Deepa, B. Shah & C. Varghese, Epidemiology of type 2 diabetes: Indian scenario Indian J Med Res 125, March 2007, pp 217-230 4. Awatif Y. Al-Maskari,Masoud Y. Al-Maskari, Salem Al-Sudairy , Oral Manifest-ations and Complications of Diabetes Mellitus SQU Med J, May 2011, Vol. 11, Iss. 2, pp. 179-186, Epub. 15th May 11 5. Sarita Bajaj, Suresh Prasad, Arvind Gupta, and Vijay Bahadur Singh, Oral manifestations in type-2 diabetes and related complications Indian J Endocrinol Metab. 2012 Sep-Oct; 16(5): 777–779. 6. Ira B. Lamster, DDS, MMSc; Evanthia Lalla, DDS, MS; Wenche S. Borgnakke, DDS, PhD; George W. Taylor, DMD, DrPH , The relationship between oral health and diabetes mellitus JADA 2008;139 7. Harald Löe,DDS , Periodontal Disease: The sixth complication of diabetes mellitus Diabetes Care January 1993 v ol.16 no. 1 329-334 8. Debora. C. Mathews ,J Can The relationship between diabetes and periodontal disease.Dent Assoc 2002 Mar;68(3):161-4 9. Renata S. Leite, Nicole M. Marlow, and Jyotika K. Fernandes , Oral Health and Type 2 Diabetes Am J Med Sci. Apr 2013; 345(4): 271–273. 10. Cresio Alves, Rafaela Menezes, Marcia Brandão1 , Salivary flow and dental caries in Brazilian youth with type 1 diabetes mellitus Indian Journal of Dental Research, 23(6), 2012 11. Al-Shammari KF , Al-Ansari JM, Moussa NM, Ben-Nakhi A, Al-Arouj M, Wang HL. Association of periodontal disease severity with diabetes duration and diabetic complications in patients with type 1 diabetes mellitus. J Int Acad Periodontol. 2006 Oct;8(4):109-14 12. Ahmad Ahmadzadeh Amiri, Avideh Mabou-di, Adele Bahar, Asadollah Farokhfar, Fatemeh Daneshvar, Hamid Reza Khoshgo-eian, Mehdi Nasohi, and Alireza Khalilian , Relationship between Type 2 Diabetic Retinopathy and Periodontal Disease inIranian Adults N Am J Med Sci. Mar 2014; 6(3): 139–144 13. Hakem H. El Sayed, Zeinab El Sanbary Relation between Diabetic Retinopathy and Diabetic Periodontitis. 14. Wahid A , Chaudhry S , Ehsan A , Butt S , Ali Khan A , Bidirectional Relationship between Chronic Kidney Disease & Periodontal Disease. Pak J Med Sci. 2013 Jan;29(1):211-5Abstract
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