Fighting Diabetes with Toothbrushes
FOR YEARS, THE BONE LOSS that accompanies gum disease was thought to be entirely bacteria-driven, says Michael Reddy, D.M.D., D.M.Sc., professor and chair of UAB’s Department of Periodontics. “Now, we believe that although it’s the bacteria that begin the disease, it’s the inflammatory response that actually causes bone loss and contributes to serious conditions elsewhere in the body, including heart disease and diabetes.”
The gum disease-diabetes link is particularly intriguing. UAB is one of three academic medical centers in the United States participating in a National Institutes of Health-funded trial to study the connection. “We have known for some time that people with diabetes have poor periodontal health,” explains Reddy, who, along with Cora E. Lewis, M.D., M.S.P.H., of the Division of Preventive Medicine, is the co-principal investigator for the trial.
“When people with diabetes have an infection, they have trouble with blood sugar control,” he says. “Inflammatory molecules that are part of the immune response to gum disease enter the circulatory system, causing systemic inflammation that disrupts the pathways that control insulin.” Previous studies in this area have produced encouraging results, showing that a cleaner, less-inflamed mouth can improve blood sugar control, but Reddy says they’ve been too small to be conclusive. “This is the first large, multicenter study to look at this question,” he says. Trial investigators are recruiting 600 participants who have both type 2 diabetes and gum disease.
“We’re working closely with patients, providing the treatments and education needed to eliminate inflammation,” Reddy says. “After six months of oral hygiene instruction and therapy, we’ll see how their blood glucose levels have changed. If treating chronic gum disease can help control blood glucose, the implications could be very significant to patient care.”