Prevention of Periodontal Disease for Overall Management of Diabetes

The number of diabetic subjects is increasing dramatically in eastern Asia, due possibly to the rapid changes of the life style. In Japan, diabetes is now recognized as the Nation's Disease of the 21st century. Effective prevention of onset and progression of diabetes contributes not only to the enhancement of so-called “quality of life” in the elderly, but also to saving the cost for medical care. It has been suggested that mild inflammation is involved in the patho-physiology of diabetes. Typical example of such sub-clinical inflammatory state is obesity. Obesity is the most powerful and, thus, well-characterized risk factor for type 2 diabetes. Periodontal disease is being recognized as another important sub-clinical inflammation. However, socially, such a concept is not widely accepted yet. Periodontal disease is the sixth complication of diabetes mellitus. Many diabetic subjects therefore develop periodontitis. If periodontitis in such subjects, in turn, greatly influences patho-physiology of diabetes, it is essential to provide such knowledge to the people who are not aware of this. The purpose of this open lecture is, 1) to summarize the nature of chronic inflammatory periodontal disease, 2) to explain why diabetic subjects are prone to periodontal disease, 3) to provide recent paradox knowledge that periodontal inflammation exacerbate blood glucose control in diabetic subjects, 4) to provide the possibility that periodontal infection is associated with macrovascular disorders, the leading cause of morbidity and mortality in diabetic subjects, and 5) to ultimately emphasize the importance of the prevention of the onset and progression of periodontal disease for overall of management of diabetes.,