A University at Buffalo researcher advised medical professionals treating patients with type 2 diabetes (T2D) to examine their patients’ teeth. Eskan, a study published in PLOS ONE on April 14, showed that T2D patients with complete chewing function had blood glucose levels that were significantly lower than patients with reduced chewing function. Eskan serves as a clinical assistant professor in the Department of Periodontics and Endodontics at the UB School of Dental Medicine.
Data from 94 T2D patients seen in the outpatient clinic of a hospital in Istanbul, Turkey, were examined in a retrospective analysis. Patients were divided into two groups.
The first group consisted of patients with strong “occlusal function”—enough teeth that were positioned correctly and made contact with each other to allow effective chewing. The blood glucose level in that group was 7.48. The second group had blood glucose levels 2 percent higher, at 9.42, and were unable to chew because they had lost part or all of their teeth.
When you sit at a picnic table with family and friends, kissing—chewing—is the last thing on your mind. However, as soon as you bite into your burger, several things begin to happen. Digestion, the process by which your body extracts nutrients from food, begins as chewing stimulates the production of saliva. Nutrients important to lowering blood glucose include fiber, which is obtained in large amounts by chewing appropriate foods.
Chewing has been reported to stimulate responses in the gut that increase insulin secretion, and the hypothalamus that promote feelings of satiety, resulting in less food consumption. Eating less food reduces the likelihood of being overweight, which is a major risk factor for developing T2D.
Eskan received his DDS at Hacettepe University, a leading medical research center in Turkey, and his PhD at the University of Louisville, where he also completed a residency in periodontology. “My particular clinical interest is treating patients with teeth that are systemically compromised,” he said. Her research goal is to contribute to the bigger picture of public health improvement. This research states that by 2019, nearly half a billion people worldwide will have diabetes and at least 90% of diabetic patients will have T2D.
Addressing oral health has recently become part of the approach to managing diabetes and encouraging patients to maintain a healthy weight, eat a healthy diet and quit smoking. “Our findings show that there is a strong association between kissing and controlling blood glucose levels among T2D patients,” Eskan said. This study did not find any independent variables that could affect blood glucose levels in the subjects because there were no statistical differences between subjects regarding body mass index (BMI), sex, smoking status, medication, or white blood cell count (infection). WBC) at baseline.
The dramatic improvement in one patient’s case described in a 2020 study co-led by Askin illustrates the potential benefit of improving occlusal function through dental implants and appropriate fixed restorations. A T2D patient whose chewing function was severely impaired due to missing teeth presented with a blood glucose level of 9.1. The patient received nutrition using a bottle and eating baby food. Four months after treatment with a full mouth implant-supported fixed restoration, the patient’s glucose level dropped to 7.8. After 18 months, it dropped to 6.2.
Research has shown that just a 1% increase in blood glucose levels is associated with a 40 percent increase in mortality from cardiovascular or ischemic heart disease in people with diabetes, according to Escan. Other complications can include kidney disease, eye damage, neuropathy, and delayed healing of common wounds such as cuts and blisters.
“I’m now interested in research that can improve people’s health,” Askon said. He and co-author Yetter E. Bayram, MD, Department of Internal Medicine, Hamidy Sisli Education and Research Hospital in Istanbul, looks forward to further studies that explore possible causal relationships between occlusal support and blood glucose levels.
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