Diabetes

Question 1

List the risk factors for gestational diabetes

Answer 1

• Over 30 years of age
• Family history of type 2 diabetes
• Overweight
• ATSI
• Gestational diabetes during previous pregnancies
• Difficulty carrying a pregnancy to term
• Certain ethnic groups: Indian, Vietnamese, Chinese, Middle Eastern, Polynesian/Melanesian

Question 2

State whether diabetes can cause dental caries

Answer 2

• No clear association has been identified
• However, people with diabetes have dry mouth/ xerostomia, periodontal issue and experience salivary dysfunction. These are risk factors for caries

Question 3

Describe the histological effects of chronic hyperglycaemia on the periodontium

Answer 3

• Stimulates macrophages -> IL-1 and TNFa = tissue destruction
• Impaired chemotaxis -> increased collagenase = tissue destruction
• Impaired chemotaxis -> reduced PMNs = impaired host defences = tissue destruction
• Causes glycation of capillaries = thickening/ weakening = poor healing
• Altered fibroblast activity = poor healing

Question 4

Describe what Hba1c is and its significance to diabetics, including the target range

Answer 4

• Known as amount of glucose attached to haemoglobin in red blood cells
• Measuring HbA1c provides an overall picture of what average blood sugar levels have been over a period of weeks/months
• This is important as the higher the HbA1c, the greater the risk of developing diabetes-related complications
• The usual target for HbA1c is less than 7%