There's Proof Gum Disease Could Lead to Gestational Diabetes

March 26, 2008

Pregnant women who have gum disease are more apt to develop gestational diabetes than pregnant women who do not have periodontal disease. This is the finding of the study conducted by a research team at the College of Dentistry of New York University.

Dr. Ananda P. Dasanayake of the university's College of Dentistry led the research. He is a professor of epidemiology and health promotion there. His team studied 256 pregnant women at the Bellevue Center in New York through the first two thirds of their pregnancy. What did they find?

They found that twenty-two of the women developed gestational diabetes. And these women had considerably higher levels of inflammation and bacteria in their gums than the other women. They had these findings published in the Journal of Dental Research in the April 2008 issue.

This finding shows how important it is for pregnant women to keep their oral health in good condition. Dr. Dasanayake said that women who are planning to be pregnant should see a dentist to help get rid of this risk to develop this condition. They should also visit their dentist after becoming pregnant.

Dr. Dasanayake said that treating periodontal disease is safe during pregnancy. Furthermore it is an effective way of keeping the oral health, thus reducing the risk to develop this condition. There will be more similar studies that will involve groups at higher risk like the Native American and Asian women.

The ability to transport glucose to the cells while expecting is held back by gestational diabetes. This inability results in the main source of energy not reaching the cells. This condition disappears after pregnancy but these women are at risk to develop type 2 diabetes later on.

It is believed that the inflammation linked to gum disease is instrumental in the inception of gestational diabetes. It appears that the inflammation interferes with the normal work of insulin. And we know that insulin is the hormone that controls the metabolism of the glucose.

Effects of Diabetes on Dental Care

Effects of diabetes on dental care has been discussed but not to this extent. The diabetics are advised to eat healthy, do regular physical activity and take medication as prescribed, but some may not know that these medications to control insulin may result in unforeseen events in dental offices.

The diabetics have to tell their dentists their special needs to avoid the harmful effects of diabetes due to the interaction between the medications and the materials used at dental offices. This study was published in the AGD's clinical journal called General Dentistry.

Lee Shackelford, DDS, FAGD, said that it is very important to inform the dentists of the special needs of the diabetics so that the dentists can foresee and prepare for the medical interactions and physical response to treatment that can occur.

The dentists have to know if the patient is taking insulin treatment and have taken their everyday dose. This will also help foresee how long the appointment will take. This is important as any medication may interact with whatever agents the dentists may use.

Really, this alert is not just for the diabetics but for the general population as well. James Little, DMD, MS, the main author of this study, advised everyone to inform their dentists with a complete information regarding prescription drugs, herbal drugs and over the counter medications as they may interact with the materials used during the dental appointments.

The excellent way to avoid the harmful effects of diabetes on the care of the oral health is an open communication with the dentists. This way any interaction can be anticipated and prepared for. There are steps the diabetic patients can take to get the best treatment possible:

• Look for a dentist who understands the needs of diabetics.
• Visit the dentist regularly and alert him to any changes in medications and in overall health condition.
• Let the dentist know of any painful areas, swelling, sore or redness in the mouth.
• Before the appointment, have a meal that is normally taken and the medication on schedule.
• Bring the blood glucose monitor and let the dentist know when experiencing low blood sugar.

Keeping Teeth and Gums Healthy

Weight Loss More Effective Than Intensive Insulin Treatment

Professor of internal medicine at the UT Southwestern Medical Center, Dr. Roger Unger, reported on his and the findings of other labs linking resistance to insulin to excess buildup of fatty molecules in the muscle and liver. The Journal of the American Medical Association published this finding on March 12.

The National Institutes of Health's National Heart, Lung and Blood Institute stopped a clinical trial when more than 250 participants died while they were on intensive therapy to lower their blood glucose level to below the present clinical guidelines.

There is proof that some tissues are stuffed with fatty molecules with high insulin levels. This leads to insulin resistance. It is therefore ironic that the insulin-resistant type 2 diabetics who are obese are treated with increasing quantity of insulin in order to overcome the resistance. The trouble with this is that while it is true that the glucose levels may go down, it also increases the fatty molecules that may lead to damage to organs.

After having investigated insulin resistance, obesity and diabetes for more than fifty years, Dr. Unger said that intensive insulin treatment for obese type 2 diabetics is contraindicated because giving more insulin just increases the body fat.

So what is the most rational treatment? The answer to this is to get rid of the extra calories which will reduce the insulin amount in the blood and the fatty acids that were stimulated by the high level of insulin. We are therefore back to square 1 which is weight loss and lifestyle changes These may be more effectual than the intensive insulin treatment.

Before, the only treatment for diabetes was to starve oneself. It is a good thing that now there are more options like bariatric surgery to lower the fat content before giving insulin. What is causing diabetes is the fat that leads to insulin resistance and the destruction of the cells that produce insulin. Going on intensive insulin therapy should be done only after all the other treatments fail.

Silent Chronic Kidney Disease Now More Accurately Identified

This is good news for the diabetics because the problem with CKD (chronic kidney disease) is that people are not aware of it until it is late. The reason? There are no symptoms in the early phase when if it is treated near the beginning, the consequences of kidney failure, heart disease and death may be stopped or delayed.

CKD is a serious disease that is not diagnosed and treated early enough because of the lack of signs that it is present. This led to a study and national survey conducted by researchers from University of North Carolina and Weill Cornell Medical College.

From this they were able to show how a simple questionnaire can spot those at risk for CKD better than what is presently used called KEEP (Kidney Early Evaluation Program) which is described in the clinical practice guidelines of the National Kidney Foundation.

They call this new way of identifying those with CKD risk SCORED (SCreening for Occult REnal Disease). This way of identifying those at risk for kidney disease is more accurate than KEEP and has less than 25% identified thus eliminating follow-up check-ups. The Archives of Internal Medicine recently published this finding.

SCORED got high marks of 88-95% in how well it recognizes people with the disease when compared with KEEP's statistics at 86-92%. As to how well the two recognized the people without the disease, SCORED got a mark of 55-65% while KEEP received a mark of 24-35%.

The main author of the study from the Weill Cornell Medical College's Division of Biostatistics and Epidemiology, assistant professor Dr. Heejung, said that this finding highlights the need to be watchful regarding the identification of those at risk for CKD especially statistics show that 13% of Americans has this silent disease and people are not aware of it.

Watch for an update on this where the questionnaire will be available. It is crucial to have this information as anyone can even do a self-assessment before heading to the doctor for the final analysis that it deserves a whole web page devoted to it.

Weight-Loss Surgery Cures Obese Diabetics

A new study reported its findings in the JAMA (Journal of American Medical Association). The report is on bariatric surgery that they say cures three of every four obese diabetics. Authorities say that this can lead to changes in the diabetes treatment as important as the insulin discovery.

Richard Collier, MD. said that they're happy to see a medical study document showing how type 2 diabetics can lose weight steadily to the point that they could lessen or do away with oral medications and insulin. Dr. Collier and his colleagues Drs. Ata Ahmad and Matthew St. Laurent do gastric band surgery at Houston's JourneyLite.

This is what they found in the study as JAMA reported. The researchers found 73% of the patients who had their stomachs reduced through surgery were cured of type 2 diabetes. They compared this figure with the diabetics who followed some other treatment interventions like losing weight, taking medication and dieting.

In the United States, diabetes is the fifth cause of death which has risen to 50% in the last 20 years. Since obesity has been found to trigger type 2 diabetes, it follows how important it is to find ways to face the challenge of what this extra weight brings to the equation.

Obesity has more than doubled from 15% in 1976 to 32.9% in 2004. The link to the condition is beyond question for there is no doubt that the figure for diabetes has risen as well. Almost 20 million Americans are now afflicted with type 2 diabetes.

It is encouraging to note though that more and more people are aware of eating healthy meals and of the benefit of physical activity. This gives hope that we may see a reversal in the statistics in the near future. Let us hope and see.

Now the question is how do gastric bands work. The researchers placed a band through surgery about the area of the top of the stomach. Then they stitched part of the stomach over the band to hold it in place with an access port secured nearer the skin.

A saline solution is then inserted into the access port which goes through a silicon tubing filling the inflation membrane. This makes the band tighter and narrowing the opening of the stomach thus making the space smaller. This gives a feeling of fullness thus limiting the food intake.

Study Found Hispanics Have Higher Blood Glucose Levels in Tests

When tested how well diabetics were controlling their blood glucose levels, the study found the Hispanics to have higher levels than those who were not Hispanics. This was reported by the Winston Salem Journal in the Diabetes Care's February issue.

Julienne Kirk, the lead author of this study, is an associate professor at the School of Medicine in Wake Forest University's family and community medicine. She and her peers examined eleven studies holding the results of A1C tests of Hispanics and non Hispanic whites.

Hemoglobin levels that are associated with glucose are measured by the A1C tests. The higher the readings, the more it shows the difficulty in managing the blood glucose. The participants of this study did not have prediabetes and gestational diabetes.

The research team found out that the biggest difference for the A1C was found among those who were registered in the insurance groups that were non-managed. The findings did not surprise the research team members knowing that diabetes disproportionately affects the minorities in the United States.

Julienne Kirk explained that the Hispanics generally have lower incomes. Not only do they have limited contact with health care but also most do not have health insurance. This explains the higher occurrence of diabetes among the Hispanics.

There is also the problem of communication. The lack of communication skill may prevent some from assessing health care. In addition, some Hispanics do not trust the health system and this may also prevent them from managing their glucose level effectively.

This study may help the Hispanics get the motivation they need to get early treatment. Awareness of health care access will give the Hispanics the change of attitude they need so they will try to get the help they need. This is the only way to close the gap in the health inequality of the Hispanics.
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