Abstract
Many cross sectional and longitudinal epidemiologic studies have consistently found greater prevalence and incidence of periodontal disease in patients. The majority of mechanisms that accelerate periodontal disease (PD) are influenced bi-directionally primarily by inflammatory responses resulting from diabetes and oral infectious processes. For decades, medicine and dentistry have been practiced in silos. This interrelationship between diabetes and PD identifies a need to establish interdisciplinary care between the medical and dental providers. Early intervention and lifestyle modifications effectively delay or prevent incidence of diabetes. Leveraging informatics can support development of screening tools. The chapter provides an outline of the prevalence, systemic and oral manifestations surrounding diabetes, technological implications, existing risk assessment tools and care plans that can serve as a guide to improve the health of patients with diabetes and periodontal disease.
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References
Acharya A, Cheng B, Koralkar R, Olson B, Lamster I, Kunzel C, Lalla E. Secondary analysis of EHR data to enhance care of dental patients with diabetes. JDR Clin Transl Res. 2018;3(2):188–94. https://doi.org/10.1177/2380084418759496.
Allen E, Matthews J, O’Halloran D, Griffiths H, Chapple IL. Oxidative and inflammatory status in Type 2 diabetes patients with periodontitis. J Clin Periodontol. 2011;38(10):894–901. https://doi.org/10.1111/j.1600-051X.2011.01764.x.
Al-Maskari A, Al-Maskari M, Al-Sudairy S. Oral manifestations and complications of diabetes mellitus: a review. Sultan Qaboos Univ Med J. 2011;11(2):179–86. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/21969888
American Academy of Periodontology. American Academy of Periodontology statement on risk assessment. J Periodontol. 2008;79(2):202. https://doi.org/10.1902/jop.2008.082001.
American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2009;33(Suppl 1):S62–7. https://doi.org/10.2337/dc09-S062.
American Diabetes Association. American Diabetes Association Releases 2018 standards of medical care in diabetes, with notable new recommendations for people with cardiovascular disease and diabetes. American Diabetes Association®; 2018a. http://www.diabetes.org/newsroom/press-releases/2017/american-diabetes-association-2018-release-standards-of-medical-care-in-diabetes.html. Accessed 1 July 2018.
American Diabetes Association. Diabetes complications. 2018b. http://www.diabetes.org/living-with-diabetes/complications/. Accessed 1 July 2018.
American Diabetes Association. Hyperosmolar hyperglycemic nonketotic syndrome (HHNS). American Diabetes Association®; 2018c. http://www.diabetes.org/living-with-diabetes/complications/hyperosmolar-hyperglycemic.html. Accessed 1 July 2018.
American Diabetes Association. Statistics about diabetes: American Diabetes Association®; 2018d. http://www.diabetes.org/diabetes-basics/statistics/. Accessed 1 July 2018.
American Diabetes Association. 2. Classification and diagnosis of diabetes: standards of medical care in Diabetes-2018. Diabetes Care. 2018e;41(Suppl 1):S13–27. https://doi.org/10.2337/dc18-S002.
American Diabetes Association. Type 2 diabetes. 2018f. http://www.diabetes.org/diabetes-basics/type-2/. Accessed 1 July 2018.
American Diabetes Association. Type 2 diabetes risk test. American Diabetes Association®; 2018g. http://www.diabetes.org/are-you-at-risk/diabetes-risk-test/. Accessed 1 July 2018.
American Diabetes Association (ADA). American Diabetes Association standards of medical care in diabetes - 2016. Diabetes Care. 2016;39(Suppl):S1–S112. https://doi.org/10.2337/dc16-S003.
Andersen LW, Mackenhauer J, Roberts J, Berg K, Cocchi M, Donnino M. Etiology and therapeutic approach to elevated lactate levels. Mayo Clin Proc. 2013;88(10):1127–40. https://doi.org/10.1016/j.mayocp.2013.06.012.
Bascones-Martinez A, Matesanz-Perez P. Periodontal disease and diabetes-review of the literature. Med Oral Patol Oral Cir. 2011;16(6):e722–9.
Bascones-Martínez A, Muñoz-Corcuera M, Bascones-Ilundain J. Diabetes y periodontitis: una relación bidireccional. Med Clin. 2015;145(1):31–5. https://doi.org/10.1016/j.medcli.2014.07.019.
Borgnakke W, Ylostalo P, Taylor G, Genco R. Effect of periodontal disease on diabetes: systematic review of epidemiologic observational evidence. J Periodontol. 2013;84(4 Suppl):S135–52. https://doi.org/10.1902/jop.2013.1340013.
Boyle J, Thompson T, Gregg E, Barker L, Williamson D. Projection of the year 2050 burden of diabetes in the US adult population: dynamic modeling of incidence, mortality, and prediabetes prevalence. Population Health Metrics. 2010;8(1):29. https://doi.org/10.1186/1478-7954-8-29.
Brownlee M. The pathobiology of diabetic complications: a unifying mechanism. Diabetes. 2005;54(6):1615–25. https://doi.org/10.2337/DIABETES.54.6.1615.
Cade W. Diabetes-related microvascular and macrovascular diseases in the physical therapy setting. Phys Ther. 2008;88(11):1322–35. https://doi.org/10.2522/ptj.20080008.
Cantais J, Cantais J, Dominguez D, Gigante V, Laera L, Tamma V. An example of food ontology for diabetes control. Proceedings of the International Semantic Web Conference 2005 Workshop on Ontology Patterns for the Semantic Web. 2005. http://citeseerx.ist.psu.edu/viewdoc/summary?doi=10.1.1.137.8373
Casanova L, Hughes F, Preshaw P. Diabetes and periodontal disease: a two-way relationship. BDJ. 2014;217(8):433–7. https://doi.org/10.1038/sj.bdj.2014.907.
Casqueiro J, Casqueiro J, Alves C. Infections in patients with diabetes mellitus: a review of pathogenesis. Indian J Endocrinol Metab. 2012;16(Suppl 1):S27–36. https://doi.org/10.4103/2230-8210.94253.
Centers for Disease Control and Prevention. National Diabetes Statistics Report, 2017 estimates of diabetes and its burden in the United States background. 2017.
Centers for Disease Control and Prevention National Center for Health Statistics National Vital Statistics System. ClinicalQualityMeasures. 2018. https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/ClinicalQualityMeasures.html
Chang P, Lim L. Interrelationships of periodontitis and diabetes: a review of the current literature. J Dent Sci. 2012;7(3):272–82. https://doi.org/10.1016/J.JDS.2012.02.002.
DHS. Diabetes: Part of the Wisconsin chronic disease prevention program. Wisconsin: Wisconsin Department of Health Services; 2018.
Dorcely B, Katz K, Jagannathan R, Chiang S, Oluwadare B, Goldberg I, Bergman M. Novel biomarkers for prediabetes, diabetes, and associated complications. Diabetes Metab Syndr Obes. 2017;10:345–61. https://doi.org/10.2147/DMSO.S100074.
Douglass C. Risk assessment and management of periodontal disease. J Am Dent Assoc. 2006;137(Suppl):27S–32S. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/17035673
Eke P, Dye B, Wei L, Slade G, Thornton-Evans G, Borgnakke W, et al. Update on prevalence of periodontitis in adults in the United States: NHANES 2009 to 2012. J Periodontol. 2015;86(5):611–22. https://doi.org/10.1902/jop.2015.140520.
Engebretson S, Kocher T. Evidence that periodontal treatment improves diabetes outcomes: a systematic review and meta-analysis. J Clin Periodontol. 2013;40:S153–63. https://doi.org/10.1111/jcpe.12084.
Glurich I, Schwei K, Lindeberg S, Shimpi N, Acharya A. Interdisciplinary diabetes management: qualitative assessment of Medical/Dental Practitioners’ Perspectives. San Francisco: International Association for Dental Research; 2017.
HealthIT.gov. Improved diagnostics & patient outcomes. HealthIT.gov; 2017. https://www.healthit.gov/topic/health-it-basics/improved-diagnostics-patient-outcomes. Accessed 1 July 2018.
Hegde H, Steinmetz A, Theisen J, Koralkar R, Finnamore J, Halstead S, et al. Dental quality analytics: dental measures and provider performance dashboard. J Dent Res. 2017;96:566.
Hegde H, Koralkar R, Shimpi N, Glurich I, Panny A, Acharya A. Diabetes mellitus prediction using machine learning in a dental setting. AADR/CADR Annual Meeting. Fort Lauderdale. 2018. https://doi.org/10.3233/THC-171127
Huang D, Refaat M, Mohammedi K, Jayyousi A, Al Suwaidi J, Abi Khalil C. Macrovascular complications in patients with diabetes and prediabetes. Biomed Res Int. 2017;2017:7839101. https://doi.org/10.1155/2017/7839101.
ICD10Data.com. The Web’s free 2018 ICD-10-CM/PCS Medical Coding Reference. 2018. https://www.icd10data.com/. Accessed 1 July 2018.
Khader Y, Dauod A, El-Qaderi S, Alkafajei A, Batayha WQ. Periodontal status of diabetics compared with nondiabetics: a meta-analysis. J Diabetes Complications. 2006;20(1):59–68. https://doi.org/10.1016/j.jdiacomp.2005.05.006.
Kitabchi A, Umpierrez G, Miles J, Fisher J, Kreisberg R, Malone J, Wall B. Hyperglycemic crises in adult patients with diabetes. Diabetes Care. 2009;32(7):1335–43. https://doi.org/10.2337/dc09-9032.
Lalla E, Papapanou P. Diabetes mellitus and periodontitis: a tale of two common interrelated diseases. Nat Rev Endocrinol. 2011;7(12):738–48. https://doi.org/10.1038/nrendo.2011.106.
Lang N, Suvan J, Tonetti M. Risk factor assessment tools for the prevention of periodontitis progression a systematic review. J Clin Periodontol. 2015;42:S59–70. https://doi.org/10.1111/jcpe.12350.
Leite R, Marlow N, Fernandes J, Hermayer K. Oral health and Type 2 diabetes. Am J Med Sci. 2013;345(4):271–3. https://doi.org/10.1097/MAJ.0b013e31828bdedf.
Lilliu M, Solinas P, Cossu M, Puxeddu R, Loy F, Isola R, et al. Diabetes causes morphological changes in human submandibular gland: a morphometric study. J Oral Pathol Med. 2015;44(4):291–5. https://doi.org/10.1111/jop.12238.
Lima D, Carneiro S, Barbosa F, Saintrain M, Moizan J, Doucet J. Salivary flow and xerostomia in older patients with type 2 diabetes mellitus. PLoS One. 2017;12(8):e0180891. https://doi.org/10.1371/journal.pone.0180891.
Loesche W. Microbiology of dental decay and periodontal disease. Medical microbiology. Galveston, TX: University of Texas Medical Branch at Galveston; 1996. http://www.ncbi.nlm.nih.gov/pubmed/21413316
López-Pintor R, Casañas E, González-Serrano J, Serrano J, Ramírez L, de Arriba L, Hernández G. Xerostomia, hyposalivation, and salivary flow in diabetes patients. J Diabetes Res. 2016;2016:4372852. https://doi.org/10.1155/2016/4372852.
Mata A, Marques D, Rocha S, Francisco H, Santos C, Mesquita MF, Singh J. Effects of diabetes mellitus on salivary secretion and its composition in the human. Mol Cell Biochem. 2004;261(1):137–42. https://doi.org/10.1023/B:MCBI.0000028748.40917.6f.
Mauri-Obradors E, Merlos A, Estrugo-Devesa A, Jané-Salas E, López-López J, Viñas M. Benefits of non-surgical periodontal treatment in patients with type 2 diabetes mellitus and chronic periodontitis: a randomized controlled trial. J Clin Periodontol. 2018;45(3):345–53. https://doi.org/10.1111/jcpe.12858.
Mealey B. Periodontal disease and diabetes. A two-way street. J Am Dent Assoc. 2006;137(Suppl):26S–31S. https://doi.org/10.14219/JADA.ARCHIVE.2006.0404.
Mohan M, Jhingran R, Bains V, Gupta V, Madan R, Rizvi I, Mani K. Impact of scaling and root planing on C-reactive protein levels in gingival crevicular fluid and serum in chronic periodontitis patients with or without diabetes mellitus. J Periodontal Implant Sci. 2014;44(4):158–68. https://doi.org/10.5051/jpis.2014.44.4.158.
Mortazavi H, Baharvand M, Movahhedian A, Mohammadi M, Khodadoustan A. Xerostomia due to systemic disease: a review of 20 conditions and mechanisms. Ann Med Health Sci Res. 2014;4(4):503–10. https://doi.org/10.4103/2141-9248.139284.
NIDDK. Insulin resistance & prediabetes. NIDDK; 2018. https://www.niddk.nih.gov/health-information/diabetes/overview/what-is-diabetes/prediabetes-insulin-resistance. Accessed 1 July 2018.
Perio-Tools.com. Risk assessment. Department of Periodontology, University of Bern Switzerland; 2018. http://www.perio-tools.com/pra/en/index.asp. Accessed 1 July 2018.
Poretsky L, Liao EP. Acute and chronic complications of diabetes. Amsterdam: Elsevier; 2013.
Preshaw P, Alba A, Herrera D, Jepsen S, Konstantinidis A, Makrilakis K, Taylor R. Periodontitis and diabetes: a two-way relationship. Diabetologia. 2012;55(1):21–31. https://doi.org/10.1007/s00125-011-2342-y.
Quirino M, Birman E, Paula C. Oral manifestations of diabetes mellitus in controlled and uncontrolled patients. Braz Dent J. 1995;6(2):131–6. http://www.ncbi.nlm.nih.gov/pubmed/8688658
Röder P, Wu B, Liu Y, Han W. Pancreatic regulation of glucose homeostasis. Exp Mol Med. 2016;48(3):e219. https://doi.org/10.1038/emm.2016.6.
Scott L, Mohlke K, Bonnycastle L, Willer C, Li Y, Duren W, et al. A Genome-Wide Association Study of Type 2 Diabetes in Finns detects multiple susceptibility variants. Science. 2007;316(5829):1341–5. https://doi.org/10.1126/science.1142382.
Shafiee G, Mohajeri-Tehrani M, Pajouhi M, Larijani B. The importance of hypoglycemia in diabetic patients. J Diabetes Metab Disord. 2012;11(1):17. https://doi.org/10.1186/2251-6581-11-17.
Shimpi N, Schroeder D, Kilsdonk J, Chyou P, Glurich I, Penniman E, Acharya A. Medical providers’ oral health knowledgeability, attitudes, and practice behaviors: an opportunity for interprofessional collaboration. J Evid Based Dent Pract. 2016a;16(1):19–29. https://doi.org/10.1016/j.jebdp.2016.01.002.
Shimpi N, Schroeder D, Kilsdonk J, Ph C, Glurich I, Acharya A. Assessment of dental providers’ knowledge, behavior and attitude towards incorporating chairside screening for medical conditions: a pilot study. J Dent Oral Care Med. 2016b;2(1):102. https://doi.org/10.15744/2454-3276.2.102.
Shultis WA, Weil EJ, Looker HC, Curtis JM, Shlossman M, Genco RJ, et al. Effect of periodontitis on overt nephropathy and end-stage renal disease in type 2 diabetes. Diabetes Care. 2007;30(2):306–11. https://doi.org/10.2337/dc06-1184.
Steffes M, Sibley S, Jackson M, Thomas W. Beta-cell function and the development of diabetes-related complications in the diabetes control and complications trial. Diabetes Care. 2003;26(3):832–6. http://www.ncbi.nlm.nih.gov/pubmed/12610045
Tuso P. Prediabetes and lifestyle modification: time to prevent a preventable disease. Perm J. 2014;18(3):88–93. https://doi.org/10.7812/TPP/14-002.
USPTF. Understanding task force recommendations screening for gestational diabetes what is gestational, (January), 1–4; 2014.
Wilcox G. Insulin and insulin resistance. Clin Biochem Rev. 2005;26(2):19–39. http://www.ncbi.nlm.nih.gov/pubmed/16278749
World Health Organization. WHO. About diabetes. Geneva: WHO; 2014. http://www.who.int/diabetes/action_online/basics/en/index1.html
Wu Y, Ding Y, Tanaka Y, Zhang W. Risk factors contributing to type 2 diabetes and recent advances in the treatment and prevention. Int J Med Sci. 2014;11(11):1185–200. https://doi.org/10.7150/ijms.10001.
Yu H, Liaw S, Taggart J, Khorzoughi AR. Using ontologies to identify patients with diabetes in electronic health records. CEUR Workshop Proceedings; 2011.
Zeggini E, Weedon M, Lindgren C, Frayling T, Elliott K, Lango H, et al. Replication of genome-wide association signals in UK samples reveals risk loci for type 2 diabetes. Science (New York, NY). 2007;316(5829):1336–41. https://doi.org/10.1126/science.1142364.
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Shimpi, N. et al. (2019). Interdisciplinary Care Model: Diabetes and Oral Health. In: Acharya, A., Powell, V., Torres-Urquidy, M., Posteraro, R., Thyvalikakath, T. (eds) Integration of Medical and Dental Care and Patient Data. Health Informatics. Springer, Cham. https://doi.org/10.1007/978-3-319-98298-4_4
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