The Oral Systemic Link to Diabetes, Obesity, and Metabolic Syndrome

Diabetes, obesity, and metabolic syndrome are inextricably linked. They are all conditions of impaired glucose metabolism, or poor ability to control blood sugar levels. Periodontal disease is one of the factors that can lead to impaired glucose metabolism. One indication of this is that people with diabetes are twice as likely as people without it to have periodontal disease.

In general, type 2 diabetes, the type of the disease that is related to lifestyle factors, is relatively rare among people who are not obese, or do not have metabolic syndrome. Metabolic syndrome is, in effect, a very mild form of diabetes, and commonly occurs before the onset of diabetes. It can become increasingly severe as time passes, unless people intervene with factors such as dietary change, increased exercise, and weight loss. Metabolic syndrome is sometimes first noticed as the condition of hypoglycemia, or low blood sugar, which causes minor degrees of the same symptoms of metabolic syndrome and diabetes: weakness, hunger, irritability, and mildly impaired cognitive function.

Periodontal disease triggers blood sugar instability by impairing the ability of insulin to maintain normal levels of blood sugar. This impaired ability, known as insulin resistance, is present among the majority of people with diabetes, metabolic syndrome, or obesity.

A complication of helping to control diabetes by clearing up periodontal disease is that diabetes itself is a major cause of periodontal disease. Sometimes periodontal disease is referred to as the “sixth symptom of diabetes.” Therefore, periodontal disease and diabetes reinforce each other, and can contribute to a cycle of illness. Because of this, it’s important to treat the diabetes at the same time that periodontal disease is treated.

It has been shown in studies that treating periodontal disease alone can reduce the need for insulin. However, it is far more prudent to treat both diseases simultaneously, to intervene in the spiral of dysfunction and disease.