2d - RFOP Diabetes Flashcards

1
Q

Common complications of diabetes?

A
  • Periodontitis – “sixth complication of diabetes”

• Retinopathy

• Neuropathy

• Nephropathy

• Macrovascular and microvascular disease

• Altered wound healing

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2
Q

1
Types of diabetes?

2
What are they?

3
Caused by / associated with?

A
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3
Q

Prevalence of type 2 diabetes?

A
  • world wide epidemic
  • continues to increase
  • Prevalence increases in proportion with age
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4
Q

Risk factors for Type II Diabetes

A

• Age
• Obesity
• Lack of Exercise
• Genetic - family history
• Genetic - Racial Background- esp Indian Subcontinent, Black Carribean

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5
Q

Type 2 diabetes
What are the 4 tests we can do to diagnose ?
What is plasma glucose measured in?

Plasma glucose units in diabetes?

A
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6
Q

1
What is HbA1c?

2
Why is it useful

3
What does it tell us and what are the levels?

A
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7
Q

Why are HbA1c test important?

A
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8
Q

Effects of Diabetes on Periodontal Disease

A
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9
Q

Effect of Blood Glucose on risk of Periodontitis

A
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10
Q

How does diabetes cause this damage

A
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11
Q

What are AGE?

A

• Glucose-derived molecules
• once formed they’re Irreversible

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12
Q

What do AGE do? Why bad? ↳

A

.

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13
Q

Diabetes, lipids and periodontitis

Adiposity = high levels of fat / fat person

what does adiposity contribute to?
What do raised lipids cause ? (3)

A

.

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14
Q

what does diabetes-associated periodontitis look like clinically

A
  • No particular characteristic appearance
  • sometimes increased pocketing disproportionate to amount of plaque present
  • Sometimes periodontal abscesses
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15
Q

what is the evidence of a bidirectional link between diabetes and periodontitis?

A
  • Severe periodontitis worsens glycaemic control in DM and non-DM pts
    ↳ * Bacteria and inflammatory molecules leave periodontal tissues, enter the circulation
    and contribute to upregulated systemic inflammation
    ↳ * Leads to impaired insulin signalling and resistance
  • In Diabetic pts, relationship between periodontitis severity and diabetes complications
  • Evidence for diabetes onset in severe periodontitis patients
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16
Q

1 - Can periodontal treatment help improve diabetic status / control?
2 - Why?

A

1 - yes

  • Reduction of HbA1C following periodontal therapy
  • Reduction of 3-4mmol/mol (≈ 0.3-0.4%) in short term
    • Similar to effect of additional drug!

2 -

Reduced bacterial challenge thought to reduce systemic inflammation and improve insulin resistance and insulin signalling

17
Q

what oral observations in patients may indicate that they have undiagnosed diabetes?

A
  • Recurrent periodontal abscesses
  • Rapidly progressing periodontitis
  • Severe periodontitis
    - Particularly : those over the age of 45 years
    - Concomitant risk factors ( BMI > 25, hypertension, family history)

consider referral for testing

18
Q

what to consider when treating patients with diabetes

A
  • Regularly updated medical history – medications and level of glycaemic control
  • Precautions for insulin-using diabetics – risk of hypoglycaemia
  • Diabetics may also present with xerostomia and oral mucosal diseases
  • May also be multi-medicated eg calcium channel blocking antihypertensives - have direct relevance to periodontium - may aggravate problems
  • Part of diagnostic statement in periodontal diagnosis (diabetes = formal risk factor)