The Influence of Periodontal Burden on Metabolic Control of Diabetes—Myth or Reality?—from a Nutritional Perspective
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Purpose of Review
The effects of periodontal treatment on the metabolic control of diabetes have been extensively studied. This report summarizes current understanding on the underlying mechanisms.
All recent studies supporting the beneficial effects of periodontal treatment have common features: (1) clinically, periodontal disease in diabetics is relatively severe, (2) the subjects exhibit elevated hs-CRP level, which declines following periodontal treatment, and (3) the subjects generally do not exhibit morbid obesity. Nevertheless, the subjects with higher hs-CRP appear to develop more mature adipose tissues than the subjects with lower hs-CRP.
Inflammatory immune cells have been reported to migrate into adipose tissue, interact with adipocytes, and thereby exacerbate adipose tissue inflammation. This may be a key mechanism explaining how local periodontal inflammation influences systemic inflammation. Therefore, appropriate life style intervention is an additional requirement in addition to reducing other obvious risk factors such as smoking in the overall management of periodontal disease in subjects with diabetes.
KeywordsPeriodontal disease Diabetes Adipocyte-macrophage interaction Low-grade inflammation Life style intervention
Compliance with Ethical Standards
Conflict of Interest
All authors declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
Hiroshima study described in the article was approved by the appropriate Ethical Committee and Informed Consent was already obtained from the participants, and the study was registered in clinical trial registry (UMIN000006356).
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
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