ET ISSUE 2156 Friday 20 April 2001 Diabetes linked to gum disease
By David Derbyshire, Science Correspondent

PEOPLE with sore or bleeding gums are more likely to develop diabetes in middle age, a new study suggests.

Bacteria can enter the bloodstream more easily if people suffer from gum disease, triggering a host of conditions including non-insulant dependent diabetes, the version that usually affects people over 40.

Although the link has been long established, gum problems are usually assumed to be a side-effect of diabetes but the new review of published medical evidence was presented at a meeting of the American Academy of Periodontology yesterday. Gum disease can cause bacteria to enter the bloodstream and activate immune cells.

The activated cells produce inflammatory biological signals, or cytokines, that have a destructive effect throughout the body. Dr Anthony Iacopino, of Marquette University School of Dentistry in Milwaukee, Wisconsin, said: "In the pancreas, insulin production cells can be damaged or destroyed by the chronic 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 believes that clinical trials could find if risk of diabetes falls if oral health improves. One study re-examined by Dr Iacopino looked at 113 with diabetes and periodontal disease in 1997.

When gum disease was treated, their diabetes improved. Michael McGuire, president of the academy, said: "Until we have results from intervention studies to understand better the role periodontal disease may play in diabetes, heart disease, preterm births and respiratory disease, the best advice is to take excellent care of one's oral health."

Well, that's very interesting. I've got periodontal disease which appears to be extremely resistant to treatment. It has been thought to be a side effect of diabetes, just as the article says. Hmm. Although I had regular annual dental check-ups and have long been known as a "plaque factory," the periodontal disease wasn't diagnosed until at least six months after the diabetes diagnosis.

-- Anonymous, April 19, 2001

Answers

Response to HEALTH - Sore and bleeding gum lead to diabetes

Something that rarely enters into current medical thinking these days is vitamin deficiency. We know that lack of vitamin C will lead to scurvy, for instance, which shows up in the mouth and gums. However, rarely do dentists recognize mild scurvy in their patients, which is caused by too low an intake of vitamin C. They see the problems with the gums allright, but don't routinely go from that to vitamin therapy as a first attempt to deal with the matter.

I came upon this vitamin problem quite by accident about 40 years ago. At the time I was in my early 20's and had periodic erruptions of sores on my gums and the side of my tongue. It would give me fits for a week or so, then seem to go away for awhile. Finally, at one point it became so troublesome, and painful, that I went to see an old doctor we knew that was semi-retired in his own practice but had held a high position in a major hospital for many years in the past.

He took a look at my mouth, gums, tongue, and said it seemed like a vitamin B deficiency to him. He gave me a shot of vitamin B complex that almost made me faint, but the problem went away within a day or so. When I checked back with him on this he said I needed to supplement my diet with a good vitamin B comlex capsule and I have done so ever since. At first I would take them for awhile, then stop, and the problem came back. After I went on a regular intake of vitamin B complex I have never had it return. As we know, vitamin B deficiency can show up in the mouth as beri-beri, but I bet not one dentist in 10 knows that's what he's looking at when he sees an early indication of the problem during an exam.

Both vitamin C and vitamin B are deficient in many people's diets, and both are used up more quickly when we are under "stress" either from outside forces or internal organic problems. They are not toxic and are worth trying out for mouth problems. Vitamin C of at least 1,000mg per day. Vitamin B complex in the drug store variety tablets that are labeled "Balanced 50" which is the whole complex of B types in 50mg/50mcg each, according to the amount needed. Some of the B complex is best taken as 50mg, some as 50mcg, but the Balanced 50 has that all sorted out and combined.

-- Anonymous, April 19, 2001

Response to HEALTH - Sore and bleeding gum lead to diabetes

Good points all, Gordon. I get plenty of C from fresh fruit and veggies (usually from the whole foods place) and I take a super B-complex (among other vitamins, herbs and minerals) in addition to a one-a-day the size of a small torpedo. I've taken B-complex for years because of my vegetarian diet. My parents both lost their teeth to gum disease in their early 20s, so I guess this could be a genetic predisposition thing. If the above study is accurate, then that would explain why I'm the first in my family to develop diabetes--everyone before me lost their teeth years before it would have shown up. I'll be calling my periodontist on Monday--we've been talking about surgery and she was going to decide in July--after this, I think we should go ahead as soon as possible.

-- Anonymous, April 20, 2001