Complications of diabetes mellitus (type 1 and type 2) such as nephropathy, neuropathy, retinopathy, peripheral vascular disease, cardiovascular disease and periodontal disease develop over time in relation to the level of serum glucose control in diabetics. Periodontal disease has only recently been recognized as a complication of diabetes mellitus (type 1 and type 2). Recently we have found that control of hyperglycemia improves control of periodontal disease in diabetics. Interestingly, control of periodontitis also improves control of hyperglycemia in diabetics. Furthermore, there are similarities in the pathophysiologic presentation of periodontitis with other diabetic complications related to the accumulation of basement membrane proteins, which suggests that similar biochemical mechanisms are involved in periodontal disease and the various diabetic complications.
It would be of great interest to know which of the other diabetic complications present more frequently with periodontitis in diabetes. This information has not been gathered in a comprehensive manner, most likely due to the historical absence of periodontitis as a diabetic complication in the literature. These data acquired in this project may be of diagnostic or of predictive value, allowing health care providers to assess the relative risk of developing certain diabetic complications based on the presence of other complications including periodontitis. Further, identification of a link between periodontitis and any other diabetic complication should provide greater understanding of involved pathophysiologic mechanisms, bringing the community closer to controlling or preventing such complications.
The aim of this project is to measure the association of periodontitis with other complications of diabetes. We will collect medical history, measure diabetic retinopathy, measure glycosylated hemoglobin, measure urine protein levels, and measure a serum marker of nephropathy from consenting diabetic patients of the College of Dental Medicine. Interactions among the diabetic complications will be revealed by ANOVA.