Periodontal disease as a complication of diabetes mellitus

Taylor, George W.; Graves, Dana T.; Lamster, Ira B.

doi:10.1002/9781118887837.ch6

Cited by 67 publications

(2 citation statements)

References 111 publications

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“…Since Loë suggested to consider periodontal disease as the sixth complication of DM in 1993 (89), periodontitis became the most researched oral complication of DM. As summarized in several narrative reviews (7, 8, 90–95), meta-analysis (96, 97), and a major consensus report (98), DM is considered as a risk factor for the development, progression, and severity of periodontitis.…”

Section: Potential Oral Complications Of Diabetes Mellitusmentioning

confidence: 99%

Evaluating All Potential Oral Complications of Diabetes Mellitus

et al. 2019

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Diabetes mellitus (DM) is associated with several microvascular and macrovascular complications, such as retinopathy, nephropathy, neuropathy, and cardiovascular diseases. The pathogenesis of these complications is complex, and involves metabolic and hemodynamic disturbances, including hyperglycemia, insulin resistance, dyslipidemia, hypertension, and immune dysfunction. These disturbances initiate several damaging processes, such as increased reactive oxygen species (ROS) production, inflammation, and ischemia. These processes mainly exert their damaging effect on endothelial and nerve cells, hence the susceptibility of densely vascularized and innervated sites, such as the eyes, kidneys, and nerves. Since the oral cavity is also highly vascularized and innervated, oral complications can be expected as well. The relationship between DM and oral diseases has received considerable attention in the past few decades. However, most studies only focus on periodontitis, and still approach DM from the limited perspective of elevated blood glucose levels only. In this review, we will assess other potential oral complications as well, including: dental caries, dry mouth, oral mucosal lesions, oral cancer, taste disturbances, temporomandibular disorders, burning mouth syndrome, apical periodontitis, and peri-implant diseases. Each oral complication will be briefly introduced, followed by an assessment of the literature studying epidemiological associations with DM. We will also elaborate on pathogenic mechanisms that might explain associations between DM and oral complications. To do so, we aim to expand our perspective of DM by not only considering elevated blood glucose levels, but also including literature about the other important pathogenic mechanisms, such as insulin resistance, dyslipidemia, hypertension, and immune dysfunction.

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Section: Potential Oral Complications Of Diabetes Mellitusmentioning

confidence: 99%

Evaluating All Potential Oral Complications of Diabetes Mellitus

et al. 2019

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“…This, in turn, promotes osteoclast genesis through increased formation of RANKL receptor activator. 71 AGE-RAGE interaction also activates NFκβ and increases the production of inflammatory cytokines. 72 Neutrophils of diabetic patients release more super-oxides than normal individuals.…”

Section: Periodontal Disease In Diabetes Mellitusmentioning

confidence: 99%

Oral Health Messiers: Diabetes Mellitus Relevance

Ahmad¹,

Haque²

2021

DMSO

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This article aims to narrate the various oral complications in individuals suffering from diabetes mellitus. Google search for “diabetes mellitus and oral complications” was done. The search was also carried out for “diabetes mellitus” and its oral complications individually. Diabetes mellitus is a chronic metabolic disorder that is a global epidemic and a common cause of morbidity and mortality in the world today. Currently, there are about 422 million cases of diabetes mellitus worldwide. Diabetic patients can develop different complications in the body such as retinopathy, neuropathy, nephropathy, cardiovascular disease. Complications in the oral cavity have been observed in individuals suffering from diabetes mellitus. A study noted that more than 90% of diabetic patients suffered from oral complications. Another research has shown a greater prevalence of oral mucosal disorders in patients with diabetes mellitus than non-diabetic population: 45–88% in patients with type 2 diabetes compared to 38.3–45% in non-diabetic subjects and 44.7% in type 1 diabetic individuals compared to 25% in the non-diabetic population. Oral complications in people with diabetes are periodontal disease, dental caries, oral infections, salivary dysfunction, taste dysfunction, delayed wound healing, tongue abnormalities, halitosis, and lichen planus. The high glucose level in saliva, poor neutrophil function, neuropathy, and small vessel damage contribute to oral complications in individuals with uncontrolled diabetes. Good oral health is imperative for healthy living. Oral complications cause deterioration to the quality of life in diabetic patients. Complications like periodontal disease having a bidirectional relationship with diabetes mellitus even contribute to increased blood glucose levels in people with diabetes. This article intends to promote awareness regarding the oral health of diabetics and to stress the importance of maintaining proper oral hygiene, taking preventive measures, early detection, and appropriate management of oral complications of these patients through a multidisciplinary approach.

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IL‐6 and high glucose synergistically upregulate MMP‐1 expression by U937 mononuclear phagocytes via ERK1/2 and JNK pathways and c‐Jun

Samuvel

Sundararaj

et al. 2010

J of Cellular Biochemistry

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Matrix metalloproteinases (MMPs) play a pivotal role in tissue remodeling and destruction in inflammation-associated diseases such as cardiovascular disease and periodontal disease. Although it is known that interleukin (IL)-6 is a key proinflamatory cytokine, it remains unclear how IL-6 regulates MMP expression by mononuclear phagocytes. Furthermore, it remains undetermined how IL-6 in combination with hyperglycemia affects MMP expression. In the present study, we investigated the regulatory effect of IL-6 alone or in combination with high glucose on MMP-1 expression by U937 mononuclear phagocytes. We found that IL-6 is a powerful stimulator for MMP-1 expression and high glucose further augmented IL-6-stimulated MMP-1 expression. We also found that high glucose, IL-6, and lipopolysaccharide act in concert to stimulate MMP-1 expression. In the studies to elucidate underlying mechanisms, the extracellular signal-regulated kinase (ERK) and c-Jun N-terminal kinase (JNK) pathways were found to be required for stimulation of MMP-1 by IL-6 and high glucose. We also observed that IL-6 and high glucose stimulated the expression of c-Jun, a key subunit of AP-1 known to be essential for MMP-1 transcription. The role of c-Jun in MMP-1 expression was confirmed by the finding that suppression of c-Jun expression by RNA interference significantly inhibited MMP-1 expression. Finally, we demonstrated that similarly to U937 mononuclear phagocytes, IL-6 and high glucose also stimulated MMP-1 secretion from human primary monocytes. In conclusion, this study demonstrated that IL-6 and high glucose synergistically stimulated MMP-1 expression in mononuclear phagocytes via ERK and JNK cascades and c-Jun upregulation. KeywordsMatrix metalloproteinases; Interleukin 6; Diabetes; Mitogen-activated protein kinases Interleukin-6 (IL-6) is a multifunctional cytokine involved in the acute phase response, immunity, hematopoiesis, and inflammation [Ishihara and Hirano, 2002;Kishimoto, 2006]. IL-6 plays an essential role in many chronic inflammatory diseases such as rheumatoid arthritis, systemic-onset juvenile chronic arthritis, osteoporosis, psoriasis, and autoimmune diseases such as antigen-induced arthritis and experimental allergic encephalomyelitis [Ishihara and Hirano, 2002]. IL-6 is also important in the pathogenesis of infectious diseases such as periodontal disease [Geivelis et al., 1993;Rusconi et al., 1991]. Furthermore, IL-6 is a marker for cardiovascular disease [Kristiansen and Mandrup-Poulsen, 2005;Rattazzi et al., 2003], which is considered as an inflammatory disease. Studies have well documented that the plasma levels of IL-6 and C-reactive protein are strong independent predictors of risk of future cardiovascular events, both in patients with a history of coronary heart disease and in apparently healthy subjects [Rattazzi et al., 2003]. Numerous studies have further demonstrated that IL-6 is not just a marker for inflammation-associated diseases; it is a major player involved in the initiation and progression of the d...

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Periodontal disease as a complication of diabetes mellitus

Cited by 67 publications

References 111 publications

Evaluating All Potential Oral Complications of Diabetes Mellitus

Evaluating All Potential Oral Complications of Diabetes Mellitus

Oral Health Messiers: Diabetes Mellitus Relevance

IL‐6 and high glucose synergistically upregulate MMP‐1 expression by U937 mononuclear phagocytes via ERK1/2 and JNK pathways and c‐Jun

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