Free Literature Review On Effects Of Type 1 Diabetes Mellitus Vs. Type 2 Diabetes Mellitus

Type of paper: Literature Review

Topic: Diabetes, Health, Dentistry, Nursing, Medicine, Viruses, Blood, Sugar

Pages: 8

Words: 2200

Published: 2021/01/23

Diabetes mellitus is a condition of the body where the patient experiences high blood sugar levels. This condition might result from poor functionality of the insulin or the body’s inability to respond to insulin and sometimes both. The general symptoms that might implicate diabetes include polyuria, where the patient frequently urinates, polydipsia and plyphagia, where the patient thirsty more than usual and hungry, respectively. In addition, there are three unique types of diabetes mellitus and they are type 1 diabetes, type 2 diabetes and gestational diabetes. Type 1 diabetes, being the rare form of diabetes, implies that the body does not secrete insulin and so there is increased blood sugar in the blood. Type 2 diabetes on the other hand is the most common and involves the body not secreting enough of the insulin to meet the body needs. Finally, gestational diabetes involves pregnant women being unable to secrete enough insulin but it dissipates immediately after the pregnancy.
Oral health is vital for proper health as it ensures that the bacteria are managed. It involves activities such as brushing of teeth daily and even flossing. The worst of the dental conditions is periodontitis which involves the pulling away of the gums from teeth allowing for the accumulation of pus and germs. In addition, the germs might destroy bone and cause the teeth to fall out. Research has come to prove that there is a relationship that exists between gum diseases and diabetes in the sense that gum diseases (especially, the serious conditions) are among those complications that come with diabetes. This implies that apart from cardiovascular diseases and kidney diseases, gum diseases are a complication that must be watched out for. This paper aims to explore the effects of both type 1 and type 2 diabetes on oral health.

Literature review

The main issue that exists between diabetes and oral health is that the bacteria that are present in the gum infections have the plausibility of penetrating into the blood stream. They have the ability to worsen the symptoms of diabetes in the patients. For instance, the entry of the bacteria might further increase the blood sugar to more lethal levels that may endanger the patient’s life or they may increase the time that the body is at high sugar levels and this might end up worsening the diabetes. In other words, the increased blood sugar levels is a major risk factor for gum and tooth diseases such as dental caries, tooth decay, gum diseases such as periodontitis, fungal infections and dry mouth. In other words, poor condition of the mouth is indeed a direct indication of the presence of the diabetes among patients.
Type 1 involves the body’s inability to produce insulin and it usually occurs among the children and rarely in adults, below their 40th year. Despite the fact that the relationship between the diabetes mellitus has not been solidified, longitudinal studies have provide a positive correlation existing between the development of caries in teeth and the overall metabolic control of the patient. Therefore self-efficacy in terms of oral health implies that there is self-efficacy with the diabetes mellitus (type 1). This has served very well especially as an indicator for the metabolic control among the patients with the Type 1 diabetes. A longitudinal study performed by Shanbhog, Raju and Nandlal, (2014) aiming to detect the correlation between the risk of caries and the glucosylated hemoglobin concluded that caries risk assessment could serve as a descriptor of the overall health care for the child with Type 1 diabetes providing prognosis for the diabetes.
Type 2 involves either the body not producing enough insulin to meet the body’s needs or the body cells are resistant to the impact of the insulin. As a result of this, blood glucose sky-rockets. The high levels of glucose have been said to be in connection with higher frequency of the dental infections even though there is limited knowledge to go on the subject. However, longitudinal studies have and are still being performed on the subject due to the inexplicable possibility of the association. For instance, an assessment of the knowledge that the doctors about the relationship between the diabetes mellitus and oral health was assessed by Al-Habashneh, Barghout, Humbert, Yousef and Alwaeli (2009) where few doctors that were highly learned were the only ones in possession of such knowledge.
Despite the fact that those people with diabetes mellitus are at a high risk of dental infections, it has been discovered that the relationship between the dental diseases and diabetes is two-way in the sense that dental infections is also a risk factor for diabetes. Poorly controlled type 2 diabetes mellitus implies that there is a high risk of dental infections such as periodontitis. Recent studies suggest that those with periodontal pockets greater than 6mm are at a higher risk of having type 2 compared to those with less than 6mm. The levels of dental infections are higher in diabetic patients as compared to those normal people and this implies that diabetic patients are at a higher risk of developing oral problems. A case control study by Mohammed, Idris, Ahmed, Olav, Mustafa, Ibrahim and Astrom implied that the levels of oral problems such as missing teeth, periodontitis, tooth mobility and furcation were prevalent in the type 2 diabetes patients as compared to non-diabetics.
Apart from oral disease, the loss of teeth has been found to be associated with glycemic control among the type 2 diabetes mellitus patients. Indeed, the oral diseases in many reviewed studies, they have been associated with systemic diseases including diabetes. In addition, the loss of tooth has also been included and has been associated with the health outcomes of several diseases and even the quality of life. Tooth loss has been said to be greater among the diabetics, especially the type 2 diabetes mellitus as compared to the non-diabetic patients. Loss of teeth is the probable outcome of several dental conditions up to and including periodontitis. With that regard, the dental diseases such as the periodontitis have been associated heavily with type 2 diabetes and so the heavier the dental conditions imply an increased tooth loss.
Diabetics are further exposed to conditions such as the xerostomia which means that there is a high glucose level in the saliva (Busato, Ignácio, Brancher, Moysés, & Azevedo-Alanis, 2012). The flora that resides in the mouth depends on the food substances available to them after the meals. The availability of glucose in high amounts implies that the microorganisms will respire, grow and multiply and therefore worsen the dental conditions such as periodontitis. The increased dental problems that might result in tooth loss imply that the diabetes will in turn worsen whenever the bacteria invade the blood stream. The loss of tooth is mainly through periodontitis and dental caries and maintenance of a proper oral health will lead to no tooth loss and in so doing glycemic control will be managed reducing risks of diabetes. Huang, Peng, Fan, Jane, Liang-Tse, Chang and Chen (2012) carried out a cross-sectional study trying to associate teeth loss with type 2 diabetes and they concluded that the loss of tooth is in fact correlated with glycemic control.
Management of diabetes type 2involves the reduction in the blood sugar levels of the blood which must have escalated as a result of either cells resistance to insulin or insufficiency of the insulin. Type 1 management involves the provision of insulin to the diabetics in order to manage the increased blood sugar levels. As the research goes with the oral health, the penetration of the microbes into the blood stream might make this a very difficult case to handle. The bacteria will increase the body cell’s intolerance to insulin making it very impossible to convert the glucose for storage. The fact that the body cells generate glucose after a heavy meal, especially after lunches and supper, implies that the diabetic patients, both type 1 and type 2 are at a major risk of experiencing extreme surges of blood glucose if their oral hygiene is well below the standards.
It has been discovered that the status of oral hygiene provides an insight for the overall diabetes status of a type 1 diabetic patient, especially the dental caries. On the other hand, type 2 diabetes has been con-joined with the periodontitis in the sense that the serious series of these two infections of the mouth in the respective patients implies that the glycemic control will be poor. This is attributed to the fact that there is poor oral hygiene leading to major infestations of the blood stream making it impossible to manage the blood glucose levels. The research by Al-Habashneh (2010) implies that the patients as well as their health care providers do not have the knowledge that the increased oral diseases in a patient implies a poor glycemic control in their blood stream.

Methods and procedures

The effect of diabetes on general is a topic that has been in the shadows for a very long time even though the little research that has been carried out so far proves that there is a significant impact of diabetes on oral health and vice versa. The topic selection for this paper was decided upon the basic truth that this topic needs to be aired. The diabetic patients and care givers need to understand this fact that the oral hygiene of the patient needs to be maintained in order to ensure that there is no risk of dental infections of any kind.

Resource search

A careful review of the literature provided in the various peer reviewed articles was performed in order to generate the materials needed for this article.

Libraries and databases used

The main database used to access journals was the ebscohost since it is the most accessible and still provide easy access to the journals with the relevant topics. In addition, access to the medical websites such as the Webmd ensured a great help for accessing relevant information for this literature review.

Key words

Words used to identify the sources for this paper include type 1 diabetes mellitus, type 2 diabetes mellitus, oral health, diabetes complications, oral diseases, diabetes, periodontal disease, caries, risk assessment and children.


There is very limited information making it very difficult to provide conclusive and correlative results between oral health and diabetes mellitus. However, it is quite clear that there is a distinct relationship that exists. It is true that diabetic patients are at a higher risk of developing dental infections such as periodontitis and dental caries. This is because diabetes comes with conditions such as xerostomia which is the increased glucose levels in the salivary glands which provides sustenance to the microbes that reside in the mouth and cause the dental diseases. As a result, the diabetics are exposed to these diseases at a higher degree than non-diabetic patients. In addition, the vice versa is true in the sense that the patients who have the dental diseases are at risk of developing diabetes implying that the correlation is two-way.
The existing relationship between the type 1 diabetes mellitus and oral health is quite different from the type 2 diabetes mellitus and oral health. Despite the fact that the overall relationship is that diabetes mellitus poses an increased risk of dental diseases, the type 1 diabetes is associated with the dental caries whereas the type 2 diabetes is involved with both dental caries and periodontitis and eventually teeth loss. The dental conditions dental caries among the patients with type 1 diabetes is in such extent that the overall degree of the oral care implies the degree of the diabetes in children. The relationship serves as an indicator of glycemic control among the type 1 diabetic patients. On the other hand, the level of tooth loss can also reflect the extent of the diabetes in type 2 diabetic patients.
The level of infection with both types of diabetes can be foretold by observing the overall oral health care by a patient. This is attributable to the fact that theses microbes affect the glycemic control of these diabetic patients. For instance, a poorly maintained oral health hygiene by a diabetic patient implies that there is a considerable amount of bacteria residing in the mouth. As discussed above, these bacteria will penetrate in to the bloodstream of the individual and impact greatly on the glycemic control of the individual by either increasing the length of time that the body struggles to reduce the blood sugar levels or increase the blood sugar levels even higher than it was. It is therefore plausible that a patient with poor oral hygiene has glycemic index beyond the normal that is even considerably greater than other diabetics.
The correction of oral hygiene is indeed the best way to manage poor oral hygiene which will in fact better the glycemic control. The reduction in number of the microorganisms implies that there will be no microbes penetrating into the blood stream to interfere with the blood glucose levels. This further indicates that the diabetics will have a better glycemic control in their conditions and that the diabetes will be manageable. Oral hygiene applies to both type 1 and type 2 diabetes mellitus since both are directly influenced by dental diseases that result from poor oral hygiene. Some of the ways to manage poor oral hygiene include brushing the teeth daily, flossing and attending medical checkups frequently for any dental problems. In other words, proper control of the oral hygiene implies that there will be positive results in the overall management of the diabetes mellitus in patients.
The best recommendation is that the medical researchers should put more efforts and indulge in further research regarding the impact of diabetes mellitus on oral health of the patients. This is because there is very little knowledge that is available regarding this correlation that makes it impossible for doctors and relevant practitioners like the dietitians to make the appropriate diagnosis and managing the diabetes (Eldarrat, 2011). With this regard, the governments need to provide sufficient funds for oral health is a fundamental issue that is affecting millions within the country everyday and if it is a risk factor for diabetes, then the knowledge needs to be owned by medical practitioners to assist their patients. This is achievable with research studies that provide conclusive evidence. In a nutshell, managing oral diseases especially in diabetes, it is a major step in the management of the diabetes mellitus.


Al-Habashneh, R., Barghout, N., Humbert, L., Khader, Y., & Alwaeli, H. (2010). Diabetes and oral health: doctors' knowledge, perception and practices. Journal Of Evaluation In Clinical Practice, 16(5), 976-980. doi:10.1111/j.1365-2753.2009.01245.x
Busato, I. S., Ignácio, S. A., Brancher, J. A., Moysés, S. T., & Azevedo-Alanis, L. R. (2012). Impact of clinical status and salivary conditions on xerostomia and oral health-related quality of life of adolescents with type 1 diabetes mellitus. Community Dentistry & Oral Epidemiology, 40(1), 62-69. doi:10.1111/j.1600-0528.2011.00635.x
Eldarrat, A. H. (2011). Diabetic patients: their knowledge and perception of oral health. Libyan Journal Of Medicine, 61-5. doi:10.3402/ljm.v6i0.5691
Huang, J., Peng, Y., Fan, J., Jane, S., Tu, L., Chang, C., & Chen, M. (2013). Factors associated with numbers of remaining teeth among type 2 diabetes: a cross-sectional study. Journal Of Clinical Nursing, 22(13/14), 1926-1932. doi:10.1111/jocn.12225
Mohamed, H. G., Idris, S. B., Ahmed, M. F., Bøe, O. E., Mustafa, K., Ibrahim, S. O., & Åstrøm, A. N. (2013). Association between Oral Health Status and Type 2 Diabetes Mellitus among Sudanese Adults: A Matched Case-Control Study. Plos ONE, 8(12), 1-9. doi:10.1371/journal.pone.0082158
Shanbhog, R., Raju, V., & Nandlal, B. (2014). Correlation of oral health status of socially handicapped children with their oral heath knowledge, attitude, and practices from India. Journal Of Natural Science, Biology & Medicine, 5(1), 101-107. doi:10.4103/0976-9668.127297

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