(By Dr. Joseph D. Lim and Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI)
DIABETES goes beyond uncontrolled blood sugar.
The disease means suffering on the part of the patient, both physically, mentally – and financially.
The problem is common worldwide. Indeed, diabetes has become one of the most challenging public health issues worldwide.
In the Philippines, the number of people with diabetes has increased from 3.4?million in 20103 to 3.7?million in 2017. Each day, there are at least 100 deaths due to diabetes-related acute or chronic complications.
According to a survey conducted in 2008, among 770 Filipinos with diabetes who were recruited from general hospitals, diabetes clinics and referral clinics, 85 percent of the patients had uncontrolled diabetes.
Almost all patients (99 percent) had cardiovascular complications.
The burden of diabetes particularly affects the poor and the middle-class patients.
Diabetes-related complications could also potentially increase out-of-pocket expenses.
Diabetes means a growing financial burden. The International Diabetes Federation estimates that the mean overall diabetes-related expenditure per person with diabetes in the Philippines has increased from US$61 in 20103 to US$234 in 2017.
A study in 2008 showed that medications cost US$13/month, insulin US$20/month and transportation per US$1 visit. We don’t know the dollar-peso exchange rate in 2008.
However, if we compute the transportation cost in 2022 rates, that’s P53. And just for transportation alone.
Other costs such as laboratory tests and procedures are not included.
We highlight diabetes and its burden on the Filipino because the disease has a lot to do with oral health care.
People with diabetes, for example, are prone to tooth decay.
A new study from Rutgers University may explain why: the strength and durability of enamel and dentin, the hard substance under enamel that gives structure to teeth, are compromised in persons with diabetes.
The Rutgers researchers induced diabetes in 35 mice and compared their teeth with those of 35 healthy mice over 28 weeks.
Although the two groups started with comparable teeth, enamel grew significantly softer in the diabetic mice after 12 weeks, and the gap continued to widen throughout the study.
Significant differences in dentin microhardness arose by week 28, Rutgers University said.
“We’ve long seen elevated rates of cavity formation and tooth loss in patients with diabetes, and we’ve long known that treatments such as fillings do not last as long in such patients, but we did not know exactly why,” said Dr. Mohammad Ali Saghiri, an Assistant Professor of Restorative Dentistry at the Rutgers School of Dental Medicine.
The study advances a multiyear effort by Dr. Saghiri and other researchers to understand how diabetes affects dental health and to develop treatments that counter its negative impact.
Previous studies have established that people with diabetes have significantly elevated rates of most oral health issues, both in the teeth and the soft tissues that surround them.
Dr. Saghiri and other researchers have demonstrated that diabetes can interfere with the ongoing process of adding minerals to teeth as they wear away from normal usage.
“This is a particular focus of mine because the population of people with diabetes continues to grow rapidly,” Dr. Saghiri said. “There is a great need for treatments that will allow patients to keep their teeth healthy, but it has not been a major area for research.”
Mind you, the Rutgers study involved mice. However, the findings are relevant to people with diabetes.
***
Dr. Joseph D. Lim, Ed. D., is the former Associate Dean of the College of Dentistry, University of the East; former Dean, College of Dentistry, National University; Past President and Honorary Fellow of the Asian Oral Implant Academy; Honorary Fellow of the Japan College of Oral Implantologists; Honorary Life Member of the Thai Association of Dental Implantology; and Founding Chairman of the Philippine College of Oral Implantologists. For questions on dental health, e-mail jdlim2008@gmail.com or text 0917-8591515.
***
Dr. Kenneth Lester Lim, BS-MMG, DDM, MSc-OI, graduated Doctor of Dental Medicine, University of the Philippines, College of Dentistry, Manila, 2011; Bachelor of Science in Marketing Management, De la Salle University, Manila, 2002; and Master of Science (MSc.) in Oral Implantology, Goethe University, Frankfurt, Germany, 2019. He is an Associate Professor; Fellow, International Congress of Oral Implantologists; Member, American Academy of Implant Dentistry and Fellow, Philippine College of Oral Implantologists. For questions on dental health, e-mail limdentalcenter@gmail.com./PN
