PEOPLE who have diabetes lack a particular type of hormone called insulin, which is responsible for the body’s utilisation of sugar, proteins, and fats. While I may not be able to give accurate statistics, judging from the number of patients I have attended to over decades, I know that diabetes is a condition common among the Guyanese population. This condition is not a disease but a syndrome. A syndrome could be considered a group of diseases with a single cause.

The consequence is that people with diabetes usually experience poor heart health, weakened eyesight, chronic weakness, muscular atrophy, and complications reflected in the mouth, among other serious conditions. They frequently experience persistent thirst and often feel itchy skin. If not monitored constantly, diabetes can be fatal. People with diabetes can die from kidney failure, coma, among other serious illnesses.

The oral symptoms are believed to occur more quickly and be more severe in uncontrolled diabetes. Diminished salivary flow and burning mouth or tongue are common complaints. The area under both ears may swell due to concomitant enlargement of the parotid glands.

Diabetics produce sugar in their saliva. This relatively high glucose content inevitably results in altered plaque and changes in the normal types of bacteria found in the mouth. This situation influences the development of gum disease and dental caries. Obviously, people with diabetes do not have to eat foods containing sugar to have sugar in their mouths, and it is well-known that sugar results in dental caries.

An increased incidence of tooth decay has been found in association with uncontrolled or poorly controlled diabetes in both humans and experimental animals. This no doubt relates to increased glucose levels in saliva.

Uncontrolled diabetics have an increased susceptibility to mouth infections, including gum disease, the primary cause of tooth loss worldwide. Also seen commonly is the thickening of the gums and delayed healing. The alveolar bone, which surrounds each tooth, is often destroyed by diabetic conditions. Additionally, the blood cells responsible for combating invading germs seem to be rendered ineffective by the elevated glucose content in the blood. This simply means that the condition increases the chances of victims losing their teeth.

A persistent dry mouth, accompanied by opportunistic yeast infections, is often seen in people with diabetes. Altered taste sensations have been described as an early feature of diabetes in some individuals. This may result from the presence of altered glucose receptors or mild manifestations of diabetic nerve disease. The treatment of diabetes is designed to lower blood glucose levels and prevent complications associated with the disease. Evidence suggests that rigid metabolic control of blood glucose levels is important for successful therapy. Diet control has been used for many years to control disease by reducing the intake of starches and sugars and by minimising body fat.

People with diabetes should not receive elective dental treatment unless their condition is stabilised. Dental practitioners in all state clinics are instructed that dental treatment for such patients should be provided only with the aid of medical advice and appropriate care. In cases of emergency procedures, prophylactic antibiotics should be used to minimise the potential for postoperative infections and delayed wound healing.