Type 2 Diabetic Paper

Those who are diabetic may also be in risk of blindness (diabetic retinopathy) and nerve damage (diabetic neuropathy). Diabetic neuropathy can lead to numbness in hands and feet, foot ulcers, and eventual limb amputation (World Health Organization). Taking preventive steps can help to avoid many of the complications of diabetes.

The study had an overall total of 1150 participants. Although there were many participants to begin with, they did not provide all of the feedback the researchers had requested.  This resulted in the expulsion of their participation, so their results were not included in the final reports of the study. The number of patients that did provide the essential information added up to a total of 901. The profile for a participant was a patients diagnosed with Type 2 diabetes in the last 6 months, but has been diagnosed no more than 10 years ago. They had to be between 35-70 years of age. Their BMI had to be more or less than 24 kg/m2 and have an HbA1c more or less than 6.5%. They also had to have treatment with a diet or oral glucose lowering medication. Those needing insulin shots, had been diagnosed with chronic diseases, or had a change in diet or lifestyle 3 months prior to the study were not included in the overall

better the process and the causes of periodontal disease ( I talked to the patient

. It also proves to be fatal due in part to the development of other complications or conditions. Complications include, nerve disease, nonalcoholic fatty liver disease, periodontal (gum) disease, hearing loss, erectile dysfunction, depression, and complications of pregnancy and many others. People with diabetes have higher rates of death due to cardiovascular disease and higher rates of hospitalization for heart attacks and stroke. Diabetes is a leading cause of kidney failure, retinopathy, and nontraumatic lower limb amputations (CDC,

Treatment of periodontal disease can be broadly divided into two, non-surgical and surgical. Longitudinal comparison between non-surgical and surgical therapy had been studied extensively by groups of researchers, namely the Gothenburg, the Michigan, the Minnesota, the Nebraska, and the Arizona group. There are some heterogeneities between studies from different groups. Some studies focused on single rooted teeth, while others included molars. Majority of the studies are done in a university setting, while the Arizona study was done in private practices.

Having Type 2 Diabetes Mellitus (T2DM) is associated with oral infections. A major oral infection that will be discussed is periodontal disease. Periodontal disease and Diabetes Mellitus have a two-way relationship; periodontal disease is the sixth most common complication of Diabetes Mellitus and DM is the strongest risk factor for periodontal disease (http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0082158). A risk factor that can occur from diabetes is xerostomia; this is the condition of not having enough saliva to keep the mouth wet (http://www.nidcr.nih.gov/oralhealth/Topics/DryMouth/). As a dental hygienist, you should

Periodontal disease can lead you to lose all of your teeth. The mouth is the gateway to the rest of the body; it can be the entering passage between healthy and sick. The moment an infection grows in the mouth, the entire body automatically starts to try to fight it. “…due to significant findings supporting the association between periodontal disease and systemic conditions such as cardiovascular disease, type 2 diabetes mellitus, adverse pregnancy outcomes, and osteoporosis” (Amar and Kim). It has been suggested that the bacteria of this infection may enter the bloodstream and attach themselves to the blood vessels which then increase clot formation. These clots then lower the blood flow to the heart indicating that a heart attack is a common consequence of gum

Since diabetes depresses wound healing and creates blood vessel changes, Alice is at an increase risk of gingivitis and periodontitis. I can provide periodontal therapy if Alice is diagnosed with gum disease (Little et al., 2013, p. 236).

Some studies have been conducted but the World Workshop on Periodontics stated that controlled clinical trials that evaluated the role that occlusion had on the progression of periodontal disease in humans, was unethical. To avoid unethical situations, patient records from a private practice facility were collected and studied to see if there was a connection between occlusal discrepancies and the progression of periodontal disease. The records that were studied were from patients that had periodontal evaluations as well as occlusal assessments. All of the patients studied had periodontal disease but only some of them had occlusal decencies. After a twelve month period some patients returned and had another periodontal evaluation and occlusal assessment and the data was compared to the data that was collected twelve months prior. The data collected was compared. Patients without occlusal discrepancies and patients with occlusal discrepancies both had worsening periodontal disease after twelve months of no treatment but, the progression of periodontal disease and increased pocket probing depths

However, type 1 occurs unexpectedly and harsh, whereas type 2 occurs over a long period of time. A professional in the clinic could check the patient’s urine to see if it has little or too much sugar. Some other signs include, a patient to be very thirsty or hungry, using the restroom frequently, weakness, or blurred vison. When a patient is experiencing nervousness, unsteadiness, or sweating the patient’s blood sugar levels have most likely dropped below the normal range. Problems in a patient’s vision, kidneys, or even feet can occur from having diabetes for a long period of time. In serious cases, diabetes can cause a wound or open sore on the foot. This is called a diabetic ulcer. These can be hard to heal, and in worst cases cause the removal of the foot or lower leg. Therefore, it is very important that you treat the disease correctly and

Type two diabetes is associated with foot complications, eye disease, kidney disease, cardiovascular disease, heart disease, hearing impairment and Alzheimer’s disease (know of a link not know why though) (source 9). Foot complications is due to the high blood pressure caused by type two diabetes which furthermore leads to nerve damage and poor circulation in the lower limbs. Which may lead to foot ulcers and infection and eventually to amputation. Foot complications occur in 13% of people with diagnosed type two diabetes and 7% of people with undiagnosed type two diabetes. Eye disease is also caused by the by high blood pressure. This disease is when the high blood pressure affects the blood vessels at the back of the eye, this is found in around 21.9% of people with type two diabetes. Cardiovascular disease is once again caused by high blood pressure. The insulin is unable to deal with the high blood pressure so fats and sugar clog up the artery walls which can lead to angina, coronary heart disease or a stroke. 45% of people with diagnosed and undiagnosed type two diabetes have experienced a CVD (cardiovascular disease) event. CDV is the leading cause of death with people with type two diabetes (source

Oral health seems to all link together, by not treating one side effect different concerns can occur in the oral cavity. Periodontal disease is a disease that involves inflammation of the periodontium. “Periodontal disease causes a breakdown of the periodontium, resulting in loss of tissue attachment and destruction of the alveolar bone.” (Bird, 2015) Which means that once it’s lost, you can’t get it back. “Periodontal disease is the lead cause of tooth loss and almost 75 percent of adults have some form of periodontal disease.” (Bird, 2015) The primary cause of periodontal disease is plaque. Plaque cannot be easily removed by rinsing the mouth, so if plaque builds up and isn’t removed for a long period of time, a patient with xerostomia and bad oral hygiene can be susceptible to periodontal disease. That’s why deep cleanings performed by a dentist or hygienist is so important. A dentist or hygienist uses a scaler that is used to scrap off plaque from above and below the gum line. In some cases, a laser may also be used to remove plaque which results in the procedure being more comfortable for the patient. That’s why patients need to be informed about removing plaque themselves at least once a day. Periodontal disease begins with a vast amount of bacterial plaque, but medications can also trigger periodontal

People with diabetes are more likely to develop gum disease. This is because the immune system can be compromised in those whose diabetes is not in control. Good oral hygiene can help to prevent gingivitis, which will reduce blood sugar levels.

The Effects of Full Mouth Disinfection on Insulin Sensitivity in Type 2 Diabetes with and without Chronic Periodontitis study identified the problem of the high periodontal disease prevalence amongst individuals with poorly controlled type 2 diabetes. The researchers found periodontal prevalence rates to be generally higher in diabetics than in those free of the systemic disease (as cited Srirangarajan, Setty, Satvanaravan, & Shetty S, 2016).

It was noted that smokers were four times more likely to have periodontitis as compared to non-smokers. The study concluded that cigarette smoking is a major risk factor for developing periodontitis and could contribute to over half of the cases of periodontitis in adults. The good news is that the odds of developing periodontitis for smokers decrease after quitting (Tomar, 2000). This study is very promising in that half of all periodontitis cases in adults may be attributed to smoking cigarettes. Assuming all adults stop smoking, meeting the Office of Disease Prevention and Health Promotion objective of reducing periodontitis by 10% would be easily achieved. However, smoking is a very addictive habit and can be very hard to quit. This initiative of smoking cessation may be limited by an individual’s compliance and willingness to stop smoking.