Diabetes

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Diabetes

• Problems with control of glucose metabolism
• Normal Glucose is 100 mg/dl or 1g/l. For an
  individual with 4 liter blood volume, normal
  levels are 4 gm.
• Below 45 mg/dl may result in hypoglycemic shock
  (coma)
• Persistent level above 125 mg/dl indicates
  diabetes-results in renal, vascular, eye disease
  and peridontitis

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• Glucose stimulates the secretion of insulin and
  suppresses the secretion of glucagon.
• Insulin is synthesized in RER of beta cells and
  is packaged in to secretary vesicles in the
  golgi.
• Insulin secretion is initiated by increased
  ATP/ADP ratio within the cell.
• This condition closes membrane ATP sensitive K
  channel and depolarizes the cell.
• The voltage change opens up another channel-the
  Ca channel. The entry of Ca into the cell
  stimulated the first short phase.
• The second prolonged phase requires other
  signaling like the increased concentration of
  cytosolic long chain fatty acyl CoA molecules.
  Diacyl glycerol and protein kinase C signaling.

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Classification of Diabetes
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Type I and Type II
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Ketone body formation

• Diabetes and Starvation
• Excessive Fatty acid oxidation in mitochondria
• Acetyl CoA Acetyl CoA
• Acetoacetyl-CoA
• ?-Hydroxy-ß-methyl Glutaryl-CoA
• (HMG-CoA)
• Acetoacetate
• Acetone CO2 D-ß-hydroxybutyrate

NADH H
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Ketone Bodies

• Can be used by heart, brain and muscle for energy
• D-ß-hydroxybutyrate
• Acetoacetate
• Acetoacetyl CoA
• Acetyl CoA Acetyl CoA

Succinyl CoA Succinate
Succinyl CoAAcetoacetate
CoA Transferase
CoA
Thiolase
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Plasma concentration of Ketone Bodies in
starvation
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Periodontitis
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Symptoms of Periodontal disease
Milky white or yellowish plaque deposits, which
are usually heaviest between teeth.
Gums that have pulled away from the teeth,
leaving more of the crown of the tooth exposed
and eventually some amount of the tooth root.
Red and swollen gums that bleed, often during
brushing or flossing

• Offensive and foul odor from the oral cavity
• Burning sensation in the mouth or the tongue
• Dry mouth-sores, infection, ulcers and tooth
  decay
• Delayed wound healing

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Oral cavity and Diabetes

• Offensive and foul odor from the oral cavity
• Burning sensation in the mouth or the tongue
• Dry mouth-sores, infection, ulcers and tooth
  decay
• Delayed wound healing

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Causes of periodontal disease

• Smoking
• Genetics
• During Pregnancy
• Stress
• Medications
• Clenching or grinding your teeth
• Diabetes
• Systemic diseases e.g. rheumatoid arthritis
• HIV

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Genetics

• The study examined periodontal health in 64 pairs
  of identical and 53 pairs of fraternal twins. The
  study found that between 48 and 59 percent of the
  differences in measures of periodontal disease,
  such as attachment loss and probing depth, could
  be attributed to genetics. When correlating eight
  different clinical measures for periodontal
  disease among the two types of twins, all eight
  measures were statistically significant in the
  identical twins, while only two measures were
  significantly greater than zero in the fraternal
  twins

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Pregnancy

• Pregnant diabetics have more gingival
  inflammation and deeper pockets between their
  teeth and gums, which are symptoms of periodontal
  disease, than non-diabetic pregnant women,
  according to a new study in the Journal of
  Periodontology. These findings are significant
  because periodontal disease is a bacterial
  infection that may make diabetes more difficult
  to control. Previous studies have shown that
  periodontal disease may increase women's risk of
  delivering a preterm, low birth weight baby.

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Diabetes

• Severe periodontal disease can increase blood
  sugar, contributing to increased periods of time
  when the body functions with a high blood sugar.
  This puts diabetics at increased risk for
  diabetic complications. Thus, diabetics who have
  periodontal disease should be treated to
  eliminate the periodontal infection

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LPS and Nicotine
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