From Volume 41, Issue 2, March 2014 | Pages 144-154
The prevalence of diabetes is increasing significantly and, therefore, dental practitioners are having to manage diabetic patients on a more regular basis. Alongside the systemic effects on the various tissues and organs of the body, diabetes can adversely affect oral health and all clinicians should be aware of the issues that may arise.
Diabetes mellitus describes a metabolic disorder of multiple aetiologies, primarily affecting the utilization of carbohydrates. It is a chronic disease recognized by hyperglycaemia secondary to insufficient insulin production by the pancreas or inability of the body to utilize the insulin it produces effectively.1 Depending on the pathogenesis, diabetes mellitus may be classified as Type 1 or Type 2.
Type 1 diabetes mellitus is a deficiency of insulin secretion, usually due to auto-immune damage of pancreatic β-cells. It is considered to be a condition of the young as the peak onset is around puberty and usually starts to affect patients of less than 20 years of age. It accounts for 10% of all diabetic cases and higher rates of the condition are found in Caucasians, especially those of North European origin.2,3
Type 2 diabetes mellitus describes a condition of insulin resistance, where the utilization of endogenously produced insulin at target cells is altered. Auto-immune destruction of β-cells does not usually occur and, although patients retain the capacity for insulin production, it may be reduced in some instances.4 The condition most often presents in middle and older age, although it is now more frequently diagnosed in younger overweight individuals. Type 2 represents 90% of all cases of diabetes mellitus in the UK and is up to three times more common among those of Asian, African or Afro-Caribbean decent.3,5
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