Oral Health, U.S. 2002 Annual Report
Section 15: LINKS TO SYSTEMIC HEALTH/ MANIFESTATIONS OF SYSTEMIC DISEASE
| 15.1 |
Prevalence of type 1 and type 2 diabetes |
Diabetes mellitus is a chronic disease of metabolism. It poses a significant public health challenge for the United States. More than 16 million people in the United States have diabetes and there are about 800,000 new cases diagnosed each year. In diabetics the pancreas either does not produce enough insulin or other cells in the body do not properly respond to it. This results in an increased level of glucose in the blood and can lead to a number of serious complications. Diabetes is one of the leading causes of death and disability in the United States. The complications of diabetes include blindness, heart and blood vessel disease, strokes, kidney failure, amputations, and nerve damage. Diabetics are at increased risk for destructive periodontitis and subsequent tooth loss (Loe, 1993; Papapanou, 1996). In addition, untreated periodontitis in persons with diabetes may complicate glycemic control (Taylor, 1999). There are three types of diabetes: gestational, type 1, and type 2.
Gestational diabetes
Gestational diabetes only occurs during pregnancy. It occurs more often in African Americans, American Indians, Hispanic Americans, and in women with a family history of diabetes. It usually disappears after delivery.
Type 1 diabetes
Type 1 diabetes is an autoimmune disease. The immune system attacks the insulin-producing beta cells in the pancreas and destroys them. Little or no insulin is produced and people with type 1 diabetes have to take insulin. The causes for this disease are unknown. Type 1 diabetes accounts for about 5% to 10% of diagnosed diabetes in the United States. It usually develops in children and young adults. It is equally common in males and females, and is more common in whites than in nonwhites. Type 1 diabetics are at higher risk for a variety of oral soft tissue lesions (Guggenheimer et al., 2000) including hyperplastic gingivitis (Van Dis et al., 1988) and lichen planus (Bagan-Sebastian, 1992).
Type 2 diabetes
Type 2 diabetes is the most common form. About 90% to 95% of people with diabetes have type 2, and one-third of them have not been diagnosed. Type 2 diabetes usually develops in adults aged 40 and older and is most common in adults over age 55. African Americans, American Indians, Asian and Pacific Islander Americans, and Hispanic Americans are at higher risk than non-Hispanic whites of the same age. American Indians have the highest rates of diabetes in the world. About 80% of people with type 2 diabetes are overweight. The prevalence of diabetes in the United States will probably continue to increase for several reasons. The population is aging. Hispanic Americans and other high-risk minority groups make up the fastest-growing segment of the population. Finally, Americans are increasingly overweight and sedentary. The prevalence of diabetes in the United States is predicted to reach 8.9% of the population by 2025.
SOURCE OF DATA
The analyses reported here are based the Third National Health and Nutrition Examination Survey (NHANES III) 1988-1994, National Center for Health Statistics, Centers for Disease Control and Prevention.
- Diabetes prevalence (Figure 15.1.1)
- Among adults aged 30 and older higher percentages of persons with diabetes were observed in association with older age groups through age 79.
- The prevalence of diabetes was greater for non-Hispanic blacks and Mexican Americans compared to non-Hispanic whites.
Bullets reference data that can be found in Table 15.1.1.
REFERENCES
Bagan-Sebastian JV, Milian-Masanet MA, Penarrocha-Diago M, Jimenez Y. A clinical study of 205 patients with oral lichen planus.
J Oral Maxillofac Surg 1992;50:116–118.
Guggenheimer J, Moore PA, Rossie K, et al. Insulin-dependent diabetes mellitus and oral soft tissue pathologies. Part I: Prevalence and characteristics of noncandidal lesions.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2000;89:563–569.
Loe H. Periodontal disease: the sixth complication of diabetes mellitus. Diabetes Care 1993;16(S1):329–334.
National Diabetes Information Clearinghouse, a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The clearinghouse is available at http://www.niddk.nih.gov/health/diabetes/pubs/dmover/
dmover.htm#what
Papapanou P. Periodontal diseases: epidemiology. Ann Periodontol 1996;1:1-36.
Taylor G. Periodontal treatment and its effects on glycemic control. Oral Surg, Oral Med, Oral Pathol, Oral Radiol, Endod 1999;87:311–316.
Van Dis ML, Allen CM, Neville BW. Erythematous gingival enlargement in diabetic patients: a report four cases.
J Oral Maxillofac Surg 1988;46:794–798.
Figure 15.1.1. Percentage of persons with diabetes among adults aged 30 and older by age group and race/ethnicity
 [D]
Data source: The Third National Health and Nutrition Examination Survey (NHANES III) 1988–1994, National Center for Health Statistics, Centers for Disease Control and Prevention.
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