Diabetes

Diabetes
Diabetes mellitus is the most common of all endocrine disorders. There are two forms of diabetes mellitus: type 1 or insulin dependent and type 2, or noninsulin dependent. The hallmark oftype 1 is the destruction of the beta cells of the pancreas, which leads to hypoproduction of insulin. This type of diabetes is usually diagnosed before age 30 and the treatment requires insulinadministration. In type 2, the most common type of diabetes, the hallmark is insulin resistance, whereby target tissues do not respond to the insulin that is present and there is often a correspondinghyperinsulinemia. This form of diabetes commonly occurs later in life and can often be managed by diet modification and oral hypoglycaemic drugs, although insulin may also be necessary to treat moreadvanced cases.
Epidemiological studies have demonstrated an association between both types of diabetes and periodontal disease. Individuals with diabetes typically are found to have more periodontalattachment loss than non-diabetic subjects, even after correcting for possible confounding factors. However, increased periodontal risk is often related to duration and adequacy of control of the diabeticstate. For example, it has been noted that individuals with non-insulin-dependent diabetes mellitus have a three-fold increased risk of developing periodontal disease that can not otherwise beexplained on the basis of age, sex or oral hygiene. Furthermore, in a case-control study of insulin-dependent diabetes mellitus and periodontal disease, Thorstensson & Hugoson demonstrated that the durationof diabetes measured by the age of onset was found to be an important risk factor for future periodontal destruction. The metabolic control of diabetes has also been shown to be associated withperiodontal disease in a longitudinal study that showed that individuals with poor metabolic control had increased attachment loss compared to well-controlled subjects, despite similar oral hygiene...