Periodontitis is the commonest oral disease affecting population worldwide. This disease is notorious for the devastation of tooth supporting structures, ensuing in the loss of dentition. The etiology for this disease...Periodontitis is the commonest oral disease affecting population worldwide. This disease is notorious for the devastation of tooth supporting structures, ensuing in the loss of dentition. The etiology for this disease is bacterial biofilm, which accumulates on the teeth as dental plaque. In addition to the biofilm microorganisms, other factors such as environmental, systemic and genetic are also responsible in progression of periodontitis. Diabetes mellitus (DM) is metabolic disorder which has an impact on the global health. DM plays a crucial role in the pathogenesis of periodontitis. Periodontitis is declared as the “sixth” major complication of DM. Evidence based literature has depicted an enhanced incidence and severity of periodontitis in subjects with DM. A “two way” relationship has been purported between periodontitis and DM. Mutual management of both conditions is necessary. Periodontal therapy (PT) may assist to diminish the progression of DM and improve glycemic control. Various advanced technological facilities may be utilized for the purpose of patient education and disease management. The present paper clarifies the etio-pathogenesis of periodontitis, establishing it as a complication of DM and elaborating the various mechanisms involved in the pathogenesis. The role of PT in amelioration of DM and application of digital communication will be discussed. Overall, it is judicious to create an increased patient cognizance of the periodontitis-DM relationship. Conjunctive efforts must be undertaken by the medical and oral health care professionals for the management of periodontitis affected DM patients.展开更多
The purpose of this article was to increase the knowledge about oral manifestations and complications associated with diabetes mellitus.An overview was performed on Google,especially in recent reliable papers in relat...The purpose of this article was to increase the knowledge about oral manifestations and complications associated with diabetes mellitus.An overview was performed on Google,especially in recent reliable papers in relation to diabetes mellitus and its oral manifestations(keywords were“diabetes mellitus”,“oral manifestations”,and“oral complications”).Data were collected and the results were declared.Diabetes mellitus is one of the most common chronic disorders characterized by hyperglycemia.This disease can have many complications in various regions of the body,including the oral cavity.The important oral manifestations and complications related to diabetes include xerostomia,dental caries,gingivitis,periodontal disease,increased tendency to oral infections,burning mouth,taste disturbance,and poor wound healing.Oral complications in diabetic patients are considered major complications and can affect patients’quality of life.There is evidence that chronic oral complications in these patients have negative effects on blood glucose control,so prevention and management of the oral complications are important.展开更多
Diabetes is chronic metabolic disorder characterized by states of hyperglycemia with disturbances of carbohydrates, fat and protein metabolism. Diabetes affects millions of people globally every day and the prevalence...Diabetes is chronic metabolic disorder characterized by states of hyperglycemia with disturbances of carbohydrates, fat and protein metabolism. Diabetes affects millions of people globally every day and the prevalence of the disease is on the rise due to unhealthy diet and lifestyle. The disorder usually results to chronic complications including cardiovascular diseases, diabetic nephropathy, diabetic neuropathy, foot ulcers and diabetic eye diseases that are all preventable through secondary preventive measures. Once an individual has been diagnosed with T2DM, secondary preventive approaches are essential in preventing the occurrence of chronic complications. However, lack of awareness of these measures has been cited as the common reasons for the development of complications. The study aimed to assess the effect of social cultural and economic factors on the practice of secondary diabetes prevention among patients with Type 2 Diabetes Mellitus (T2DM) at Consolata Hospital Nkubu and Meru Level Five Hospital between March and April 2019. A descriptive correlational study design was adopted to collect data from 357 purposively sampled participants with T2DM using questionnaires and Focus Group Discussion Guide. Quantitative data were analyzed using SPSS version 25 at 95% confidence interval and a significance level p ≤ 0.05. Most respondents attended Meru Teaching and Referral Hospital. Majority of the respondents were aged between 40 - 60 years. Most respondents 31.6% had secondary level of education and majority 67% was employed. Concerning secondary prevention, majority did foot examination on every visit 70.6% and BP monitoring 69.5% while 56.5% did annual eye screening. Level of income, affordability of services, health insurance cover of the patients, monthly cost of DM management and traditional beliefs in managing DM all significantly influenced DM secondary prevention at a p value ≤ 0.05. The factors need to be addressed to reduce the global burden posed by the disease.展开更多
The exocrine structure is significantly affected by diabetes because of endocrine structure-function disorder within the pancreas. Exocrine pancreatic dysfunction (EPD) is the general name of the malabsorption process...The exocrine structure is significantly affected by diabetes because of endocrine structure-function disorder within the pancreas. Exocrine pancreatic dysfunction (EPD) is the general name of the malabsorption process resulting from inadequate production, release, decreased activation, and/or insufficient degradation of enzymes required for digestion from pancreatic acinar cells. It is important to diagnose patients early and correctly, since there may be both macro- and micro-nutrient deficiency in EPD. In this paper, EPD, the diabetes- EPD relationship, and the predictive, effective factors affecting the emergence of EPD are briefly explained and summarized with contemporary literature and our experienced based on clinical, lab, and radiological findings.展开更多
The prevalence and burden of diabetes mellitus and chronic kidney disease on global health and socioeconomic development is already heavy and still rising.Diabetes mellitus by itself is linked to adverse cardiovascula...The prevalence and burden of diabetes mellitus and chronic kidney disease on global health and socioeconomic development is already heavy and still rising.Diabetes mellitus by itself is linked to adverse cardiovascular events,and the presence of concomitant chronic kidney disease further amplifies cardiovascular risk.The culmination of traditional(male gender,smoking,advanced age,obesity,arterial hypertension and dyslipidemia)and non-traditional risk factors(anemia,inflammation,proteinuria,volume overload,mineral metabolism abnormalities,oxidative stress,etc.)contributes to advanced atherosclerosis and increased cardiovascular risk.To decrease the morbidity and mortality of these patients due to cardiovascular causes,timely and efficient cardiovascular risk assessment is of huge importance.Cardiovascular risk assessment can be based on laboratory parameters,imaging techniques,arterial stiffness parameters,ankle-brachial index and 24 h blood pressure measurements.Newer methods include epigenetic markers,soluble adhesion molecules,cytokines and markers of oxidative stress.In this review,the authors present several non-invasive methods of cardiovascular risk assessment in patients with diabetes mellitus and chronic kidney disease.展开更多
Type 1 diabetes mellitus(T1DM)is one of the important causes of chronic kidney disease(CKD)and end-stage renal failure(ESRF).Even with the best available treatment options,management of T1DM poses significant challeng...Type 1 diabetes mellitus(T1DM)is one of the important causes of chronic kidney disease(CKD)and end-stage renal failure(ESRF).Even with the best available treatment options,management of T1DM poses significant challenges for clinicians across the world,especially when associated with CKD and ESRF.Substantial increases in morbidity and mortality along with marked rise in treatment costs and marked reduction of quality of life are the usual consequences of onset of CKD and progression to ESRF in patients with T1DM.Simultaneous pancreas-kidney transplant(SPK)is an attractive and promising treatment option for patients with advanced CKD/ESRF and T1DM for potential cure of these diseases and possibly several complications.However,limited availability of the organs for transplantation,the need for long-term immunosuppression to prevent rejection,peri-and post-operative complications of SPK,lack of resources and the expertise for the procedure in many centers,and the cost implications related to the surgery and postoperative care of these patients are major issues faced by clinicians across the globe.This clinical update review compiles the latest evidence and current recommendations of SPK for patients with T1DM and advanced CKD/ESRF to enable clinicians to care for these diseases.展开更多
Objective To observe the therapeutic effect of non-surgical treatment on diabetic Chinese withchronic periodontitis. Methods Moderate to advanced chronic periodontitis ( CP) was studied in 36 diabetes mellitus (DM) pa...Objective To observe the therapeutic effect of non-surgical treatment on diabetic Chinese withchronic periodontitis. Methods Moderate to advanced chronic periodontitis ( CP) was studied in 36 diabetes mellitus (DM) patients classified as 20 with high and fluctuating blood glucose level (DM-H) and 16 with relatively low and stable blood glucose level (DM-L). 28 non-DM CP patients acted as controls (Non-DM). Plaque index (PlI) , gingival index (GI) , bleeding on probing (BOP) , probing depth (PD) and clinical attachment loss (AL) of all patients were recorded at 6 sites on each tooth at the baseline and 1, 3 and 6 months after oral hygiene instruction (OHI), scaling and root planing. Results It was found that the short-term effect of non-surgical periodon-tal procedure had resulted in significant resolution of gingival inflammation and pronounced reduction in pocket depth and gain of attachment loss in both DM and Non-DM CP patients. Conclusion The pilot study suggested that non-surgical periodontal treatment allowed for favorable treatment responses in a group of Chinese diabetic subjects with chronic periodontitis and that their various profiles of blood glucose did not influence the short-term healing response to OHI, scaling and root planning.展开更多
The bidirectional relationship between periodontitis and type 2 diabetes mellitus has been well-established.However,the underlying molecular mechanisms remain unclear.Diabetic retinopathy(DR)is an important complicati...The bidirectional relationship between periodontitis and type 2 diabetes mellitus has been well-established.However,the underlying molecular mechanisms remain unclear.Diabetic retinopathy(DR)is an important complication of diabetes,but there are few studies on the relationship between DR and periodontitis,especially on the intrinsic inflammatory pathway mechanism.This article reviews the latest clinical data on how diabetes promotes susceptibility to periodontitis from the epidemiological and molecular perspectives,with a special focus on the key roles of systemic inflammation and endothelial dysfunction in the interplay between DR and periodontitis.Comprehension of the intertwined pathogenesis of DR and periodontitis can better guide the development of comprehensive management strategies for glycemic control and periodontal health,with the aim of mitigating the progression of DR and enhancing overall well-being.展开更多
文摘Periodontitis is the commonest oral disease affecting population worldwide. This disease is notorious for the devastation of tooth supporting structures, ensuing in the loss of dentition. The etiology for this disease is bacterial biofilm, which accumulates on the teeth as dental plaque. In addition to the biofilm microorganisms, other factors such as environmental, systemic and genetic are also responsible in progression of periodontitis. Diabetes mellitus (DM) is metabolic disorder which has an impact on the global health. DM plays a crucial role in the pathogenesis of periodontitis. Periodontitis is declared as the “sixth” major complication of DM. Evidence based literature has depicted an enhanced incidence and severity of periodontitis in subjects with DM. A “two way” relationship has been purported between periodontitis and DM. Mutual management of both conditions is necessary. Periodontal therapy (PT) may assist to diminish the progression of DM and improve glycemic control. Various advanced technological facilities may be utilized for the purpose of patient education and disease management. The present paper clarifies the etio-pathogenesis of periodontitis, establishing it as a complication of DM and elaborating the various mechanisms involved in the pathogenesis. The role of PT in amelioration of DM and application of digital communication will be discussed. Overall, it is judicious to create an increased patient cognizance of the periodontitis-DM relationship. Conjunctive efforts must be undertaken by the medical and oral health care professionals for the management of periodontitis affected DM patients.
文摘The purpose of this article was to increase the knowledge about oral manifestations and complications associated with diabetes mellitus.An overview was performed on Google,especially in recent reliable papers in relation to diabetes mellitus and its oral manifestations(keywords were“diabetes mellitus”,“oral manifestations”,and“oral complications”).Data were collected and the results were declared.Diabetes mellitus is one of the most common chronic disorders characterized by hyperglycemia.This disease can have many complications in various regions of the body,including the oral cavity.The important oral manifestations and complications related to diabetes include xerostomia,dental caries,gingivitis,periodontal disease,increased tendency to oral infections,burning mouth,taste disturbance,and poor wound healing.Oral complications in diabetic patients are considered major complications and can affect patients’quality of life.There is evidence that chronic oral complications in these patients have negative effects on blood glucose control,so prevention and management of the oral complications are important.
文摘Diabetes is chronic metabolic disorder characterized by states of hyperglycemia with disturbances of carbohydrates, fat and protein metabolism. Diabetes affects millions of people globally every day and the prevalence of the disease is on the rise due to unhealthy diet and lifestyle. The disorder usually results to chronic complications including cardiovascular diseases, diabetic nephropathy, diabetic neuropathy, foot ulcers and diabetic eye diseases that are all preventable through secondary preventive measures. Once an individual has been diagnosed with T2DM, secondary preventive approaches are essential in preventing the occurrence of chronic complications. However, lack of awareness of these measures has been cited as the common reasons for the development of complications. The study aimed to assess the effect of social cultural and economic factors on the practice of secondary diabetes prevention among patients with Type 2 Diabetes Mellitus (T2DM) at Consolata Hospital Nkubu and Meru Level Five Hospital between March and April 2019. A descriptive correlational study design was adopted to collect data from 357 purposively sampled participants with T2DM using questionnaires and Focus Group Discussion Guide. Quantitative data were analyzed using SPSS version 25 at 95% confidence interval and a significance level p ≤ 0.05. Most respondents attended Meru Teaching and Referral Hospital. Majority of the respondents were aged between 40 - 60 years. Most respondents 31.6% had secondary level of education and majority 67% was employed. Concerning secondary prevention, majority did foot examination on every visit 70.6% and BP monitoring 69.5% while 56.5% did annual eye screening. Level of income, affordability of services, health insurance cover of the patients, monthly cost of DM management and traditional beliefs in managing DM all significantly influenced DM secondary prevention at a p value ≤ 0.05. The factors need to be addressed to reduce the global burden posed by the disease.
文摘The exocrine structure is significantly affected by diabetes because of endocrine structure-function disorder within the pancreas. Exocrine pancreatic dysfunction (EPD) is the general name of the malabsorption process resulting from inadequate production, release, decreased activation, and/or insufficient degradation of enzymes required for digestion from pancreatic acinar cells. It is important to diagnose patients early and correctly, since there may be both macro- and micro-nutrient deficiency in EPD. In this paper, EPD, the diabetes- EPD relationship, and the predictive, effective factors affecting the emergence of EPD are briefly explained and summarized with contemporary literature and our experienced based on clinical, lab, and radiological findings.
文摘The prevalence and burden of diabetes mellitus and chronic kidney disease on global health and socioeconomic development is already heavy and still rising.Diabetes mellitus by itself is linked to adverse cardiovascular events,and the presence of concomitant chronic kidney disease further amplifies cardiovascular risk.The culmination of traditional(male gender,smoking,advanced age,obesity,arterial hypertension and dyslipidemia)and non-traditional risk factors(anemia,inflammation,proteinuria,volume overload,mineral metabolism abnormalities,oxidative stress,etc.)contributes to advanced atherosclerosis and increased cardiovascular risk.To decrease the morbidity and mortality of these patients due to cardiovascular causes,timely and efficient cardiovascular risk assessment is of huge importance.Cardiovascular risk assessment can be based on laboratory parameters,imaging techniques,arterial stiffness parameters,ankle-brachial index and 24 h blood pressure measurements.Newer methods include epigenetic markers,soluble adhesion molecules,cytokines and markers of oxidative stress.In this review,the authors present several non-invasive methods of cardiovascular risk assessment in patients with diabetes mellitus and chronic kidney disease.
文摘Type 1 diabetes mellitus(T1DM)is one of the important causes of chronic kidney disease(CKD)and end-stage renal failure(ESRF).Even with the best available treatment options,management of T1DM poses significant challenges for clinicians across the world,especially when associated with CKD and ESRF.Substantial increases in morbidity and mortality along with marked rise in treatment costs and marked reduction of quality of life are the usual consequences of onset of CKD and progression to ESRF in patients with T1DM.Simultaneous pancreas-kidney transplant(SPK)is an attractive and promising treatment option for patients with advanced CKD/ESRF and T1DM for potential cure of these diseases and possibly several complications.However,limited availability of the organs for transplantation,the need for long-term immunosuppression to prevent rejection,peri-and post-operative complications of SPK,lack of resources and the expertise for the procedure in many centers,and the cost implications related to the surgery and postoperative care of these patients are major issues faced by clinicians across the globe.This clinical update review compiles the latest evidence and current recommendations of SPK for patients with T1DM and advanced CKD/ESRF to enable clinicians to care for these diseases.
基金Supported by Foundation of Major Subjects of Advanced Medical Specialities in Shanghai, China (983010)
文摘Objective To observe the therapeutic effect of non-surgical treatment on diabetic Chinese withchronic periodontitis. Methods Moderate to advanced chronic periodontitis ( CP) was studied in 36 diabetes mellitus (DM) patients classified as 20 with high and fluctuating blood glucose level (DM-H) and 16 with relatively low and stable blood glucose level (DM-L). 28 non-DM CP patients acted as controls (Non-DM). Plaque index (PlI) , gingival index (GI) , bleeding on probing (BOP) , probing depth (PD) and clinical attachment loss (AL) of all patients were recorded at 6 sites on each tooth at the baseline and 1, 3 and 6 months after oral hygiene instruction (OHI), scaling and root planing. Results It was found that the short-term effect of non-surgical periodon-tal procedure had resulted in significant resolution of gingival inflammation and pronounced reduction in pocket depth and gain of attachment loss in both DM and Non-DM CP patients. Conclusion The pilot study suggested that non-surgical periodontal treatment allowed for favorable treatment responses in a group of Chinese diabetic subjects with chronic periodontitis and that their various profiles of blood glucose did not influence the short-term healing response to OHI, scaling and root planning.
基金Supported by the Zhejiang Medical Technology Project,No.2022RC009National Natural Science Foundation of China,No.81900692.
文摘The bidirectional relationship between periodontitis and type 2 diabetes mellitus has been well-established.However,the underlying molecular mechanisms remain unclear.Diabetic retinopathy(DR)is an important complication of diabetes,but there are few studies on the relationship between DR and periodontitis,especially on the intrinsic inflammatory pathway mechanism.This article reviews the latest clinical data on how diabetes promotes susceptibility to periodontitis from the epidemiological and molecular perspectives,with a special focus on the key roles of systemic inflammation and endothelial dysfunction in the interplay between DR and periodontitis.Comprehension of the intertwined pathogenesis of DR and periodontitis can better guide the development of comprehensive management strategies for glycemic control and periodontal health,with the aim of mitigating the progression of DR and enhancing overall well-being.
