by Brian Mealey

Currently, 20.8 million Americans have diabetes, according to the American Diabetic Association. About one third of those with the disease are unaware that they have it, and of those who have been diagnosed, only a little more than half have it under control.

Diabetes is a disease where the body does not produce or properly use insulin, a hormone made in the pancreas. Insulin “unlocks”cells, allowing sugars derived from carbohydrates and other food to enter. Sugar is the basic fuel for cells, providing energy for daily life.

There are two types of diabetes: In type 1 diabetes, the pancreas no longer makes insulin. Sugar cannot enter the cells and builds up in the bloodstream. In type 2, the pancreas does not produce enough insulin, or the hormone does not function properly at the cellular level, a condition called insulin resistance. In this case, too, sugar is locked out of the cells, so it builds up in the blood. In both types of diabetes, cells may be starved for energy.  Over time, high blood sugar can damage vision, even causing blindness. It can also trigger kidney failure, nerve damage and heart disease, and in people with diabetes wounds heal poorly.

Diabetes also increases the risk for periodontal disease, an infectious process that inflames gum tissue, causing them to bleed; it also destroys the bone and soft tissues that support teeth. While periodontal disease occurs in non-diabetic people, too, gum disease is more common and more severe in diabetics. Dentists monitor their diabetic patients closely for these oral conditions and may refer patients to a periodontist (gum specialist) to diagnose and treat periodontal disease. 

Brian L. Mealey is director of the Periodontics Postgraduate Program at the University of Texas Health Science Center at San Antonio—Oral and Whole Body Health

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