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Thursday, 19 April, 2001, 00:44 GMT 01:44 UK
'Bad teeth' link to diabetes
Gum disease may even contribute to diabetes
Serious dental disease could lead to diabetes, according to American researchers.

It is known that people with diabetes are more likely to have bad teeth.

But the US study suggests chronic periodontal disease may itself increase the chances of developing Type 2 diabetes.

UK dental and diabetic experts have welcomed the research, but say more work needs to be done before a link can be confirmed.

The US researchers say that in people with periodontal disease, bacteria can enter the bloodstream and trigger a reaction from the immune system.

Immune system cells release proteins called cytokines which have a damaging effect on the cells in the pancreas which produce insulin, the hormone which is key to diabetes.

Pancreas damage

The US researchers presented their findings to the American Academy of Periodontology/National Institute of Dental and Craniofacial Research symposium in Bethesda, Maryland.

Dr Anthony Iacopino, of the Division of Prosthodontics at Marquette University School of Dentistry in Milwaukee, Wisconsin, said: "In the pancreas, the cells responsible for insulin production can be damaged or destroyed by high levels of cytokines.

"Once this happens, it may induce Type 2 diabetes, even in otherwise healthy individuals with no other risk factors for diabetes."

Dr Iacopino said high cholesterol, or lipid, levels, rather than the way the body deals with glucose, was the risk factor for people who are already diabetic developing periodontal disease.

And he said lowering cholesterol levels could also help healthy people not to develop periodontal disease, which could then lead to diabetes.

"Low fat diets, lipid lowering drugs, and exercise are vitally important for diabetics who want to improve their quality of life, as well as their oral health.

"The same approaches may also be prove beneficial in non-diabetic patients with high cholesterol."

Dr Iacopino said more research was needed, particularly into whether the risk of diabetes decreases when periodontal disease is treated.

Dental disease

Gingivitis, or inflamed gums, is periodontal disease in its mildest form.

Caused by bacteria in plaque, it can be cured. But if it is left untreated it can develop into periodontal disease.

Gaps can form between the teeth and gums, which may become infected, and in the most serious cases, teeth may have to be removed.

Diabetes is a condition where the body is unable to regulate glucose properly, meaning levels in the blood can become too high.

Insulin treatment helps the body control the levels of glucose in the bloodstream.

In Type 2 diabetes, either too little insulin is produced, or it is not having enough effect on the body.

It usually affects people over the age of 40, and is controlled by changing diet, taking pills or having regular injections.

'Trials needed'

A spokeswoman for Diabetes UK said: "We would want to see a lot more clinical studies and intervention trials into the possibility of a link between periodontal disease and diabetes."

She added: "There is no one process that results in diabetes, whether Type 1 or Type 2.

"As yet, we do not know all the genes responsible for predisposing individuals to developing diabetes, and we do not know what specific environmental factors are necessary to trigger the condition."

A spokeswoman for the British Dental Association (BDA) said there was a growing body of evidence linking periodontal disease and other medical conditions including diabetes.

She added: "Studies are currently underway to explore further the relationship between periodontal disease and diabetes.

"Until the findings of these studies become available, it is important for the medical and dental research communities to continue research and to communicate about their latest findings.

She repeated BDA advice that people should maintain oral health by cleaning their teeth twice a day with a fluoride toothpaste and visiting their dentist regularly.

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