Warning Signs of Diabetes: All In Your Head?

Nov. 4, 2003
"Above the Neck" signs may help identify those at risk

Approximately 17 million Americans have diabetes and according to the American Diabetes Association (ADA), one-third of them are unaware they have the disease. This November, during National Diabetes Awareness Month, the Academy of General Dentistry (AGD) and the American Optometric Association (AOA) want to educate consumers, especially those unaware they are at risk, that common warning signs of diabetes could be all in their head-literally. Bad breath, bleeding gums, blurred vision and many other oral or optic ailments can be early indicators of diabetes.

Diabetes is a chronic disease in which the body can no longer produce or use insulin properly. Insulin helps convert certain foods into glucose, or sugar, for our bodies to use for energy. Without insulin injections, individuals with diabetes can have a build-up of sugars in their blood.

There are three major types of the diabetes: Type 1, Type 2 and Gestational. Ninety to 95 percent of people with diabetes suffer from Type 2 diabetes. The prevalence of the disease is rising in the United States as the population ages and more Americans become obese, according to the National Diabetes Education Foundation.

Diabetes and the Mouth: What's the Link?
Researchers believe diabetes often manifests itself in the mouth, making the dentist a key player in diagnosis. Because of high glucose levels, people with diabetes are more likely to have problems with their teeth or gums since increased glucose levels can help bacteria thrive. The increased bacteria combined with a diabetic's inability to resist infection can lead to gum disease.

Oral symptoms related to diabetes include:
- Chronic bad breath or bad taste in mouth
- Gingivitis-Sore, swollen and red gums that bleed when you brush
- Periodontitis-gums pulling away from teeth
- Sore or loose teeth

People with diabetes need to take extra care with their teeth since they are more susceptible to oral infections and periodontal disease than those who do not have the disease. Dentists recommend brushing at least twice a day and getting a new toothbrush at least every three months to cut down on bacteria in the mouth. Flossing daily will help keep gums healthy and prevent gingivitis. People with diabetes should visit the dentist every six months and should schedule visits in accordance with insulin injections or meal times.

Diabetes and the Eyes: What's the Link?
A diabetic's increased blood glucose can also affect their eyesight. An increased amount of sugar in the blood over a long period of time can destroy blood vessels in the back of the eye, preventing the eye from getting the nutrition it needs to maintain vision. This is called diabetic retinopathy. If left untreated, diabetic retinopathy can lead to blindness. Symptoms of diabetic retinopathy can include:
- Difficulty reading
- Blurred vision
- Seeing rings around lights, dark spots or flashing lights

Early stages of diabetic retinopathy may not have symptoms so an annual eye exam can be a diabetic's first line of defense in preventing loss of vision, yet only 40 to 50 percent of individuals with diabetes are screened annually. According to the AOA, early treatment is crucial because once
the eye damage has occurred, whether it's blurred vision or blindness, the effects are usually permanent. The Centers for Disease Control (CDC) recommends individuals with diabetes and patients at risk for diabetes have their eyes dilated and examined once a year.

People with diabetes are also encouraged to keep blood glucose levels and blood pressure under control. A study done by the CDC shows that maintaining a normal blood glucose level can prevent the onset of diabetic retinopathy. Since high blood pressure can also cause eye damage, it is recommended People with diabetes have their blood pressure checked at least four times a year.

Diabetes Resources
For additional information on proper oral health care, visit the AGD's Web site, www.agd.org. To locate a dentist or request a free oral and overall health care brochure, consumers across the U.S. and Canada can call toll-free 1-877-2X-A-YEAR (1-877-292-9327).