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<p>Diabetes mellitus and periodontal disease: a two-way street through health and disease<br>Lieutenant Commander John H. Wilson, DC, USN and Commander Matthew J. Gramkee, DC, USN<br><br>Introduction<br>Diabetes Mellitus (DM) affects roughly 12 million people in the US; as many as half of these people may be unaware of their condition. Two forms of the disease exist. Type I DM (formerly Insulin Dependent Diabetes Mellitus) is a result of destruction of the Islet of Langerhan cells in the pancreas, resulting in a lack of endogenous insulin production. Type II DM (formerly Non-Insulin Dependent Diabetes Mellitus) comprises 85-90% of diabetes cases, and is a result of impaired insulin receptors on the target cells. Periodontal dis-ease includes a spectrum of plaque-induced, inflammatory conditions affecting gingiva, cementum, and alveolar bone. Estimates of the prevalence of gingivitis in the US range from 39-60%, while only 5-15% of the population suffers from severe generalized periodontitis. The purpose of this clinical update is to present an evidence based review of the effects of diabetes on the clinical course of periodontal disease, as well as to argue the importance of achieving periodontal health in the overall management plan for both type I and type II diabet-ics.
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<br>Subjects: Gingiva; Gingivitis; Insulin; Periodontal Diseases; Periodontitis</div>
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U.S. Navy. Naval Postgraduate Dental School</div>
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