Grand Rounds in Oral-Systemic Medicine - May 2006 - Original Article: Combating Diabetes, Obesity, Periodontal Disease and Interrelated Inflammatory Conditions with a Syndemic Approach (Page 47)

As a result of research, we know that complications of diabe- diabetes. JAMA 2004; 291:335-342.
_tes _can _be _avoided. _Individuals _with _diabetes _no _longer _have 16. Centers for Disease Control and Prevention. Prevalence of
receiving multiple preventive-care services among adults
to anticipate experiencing the loss of vision or kidney function _with _diabetes _- _United _States, _2002-2004. _MMWR _Weekly, _Novexperienced by parents, aunts, and uncles. We have blood-glu- 11, 2005;54;1130-1133. Accessed http://www.cdc.gov/mmwr/
cose monitors to measure control, and patients are taught how ^{preview/mmwrhtml/ mm5444a5.htm,} ^2/5/06._to _manage _their _own _disease _by _adjusting _exercise _and _food _in- 17. Salvi GE, Beck JD, Offenbacher S. PGE2, IL- 1 beta, and TNF-alpha _responses _in _diabetics _as _modifiers _of _periodontal _disease. _Anntake on the basis of blood-glucose results. Likewise, knowledge of Periodontol _{1998;3: 40-50.}the relationship between chronic inflammatory conditions such 18. Grossi, S. Treatment of periodontal disease and control of diabetes:
as diabetes and oral health is evolving. This creates a need to An assessment of the evidence and need for future research. Ann
Periodontol 2001;6:138-145.
^modify ^the ^delivery ^of ^care ⁱⁿ ^medical ^and ^dental ^settings. ^Work- 19. Lamster IB, Lalla E. Periodontal disease and diabetes mellitus:
ing in a transdisciplinary manner, we can triple our successes in Discussion, conclusions and recommendations. Ann Periodontol
combating the epidemic of diabetes. ^{2001:6:146-149.} 20. American Academy of Periodontology. Position paper on diabetes
^References^and ^periodontal ^diseases. ^J ^Periodontol ^{1996;67:166-176.} 21. Scannapieco FA. American Academy of Periodontology. Position
1. USDepartmentof Healthand Human Services.National Institutes _{paper on periodontal disease as a potential risk factor for}of Health. National Heart, Lung and Blood Institute. Think Tank _systemic _diseases. _J _Periodontol _{1998;69:841-850.}^on ^Enhancing ^Obesity ^Research ^at ^the ^Heart, ^Lung, ^and ^Blood 22. American Academy of Periodontology. Position paper on diabetes
^Institute. ^NIH ^Publication ^No. ^04-5249; ^August ^2004.and periodontal diseases. J Periodontol 2000;71:664-678.

²^. ^American ^Diabetes ^Association. ^Standards ^of ^Medical ^Care ⁱⁿ 23. American Academyof Periodontology. Parameter onperiodontitis ^{Diabetes-2006.} ^Diabetes ^Care ^2006; ²⁹^(Suppl ¹^):S4-33.associated with systemic conditions. J Periodontol 2000;71:876-

3. Genco RJ, Grossi SG, Ho A, et al. A proposed model linking _879.inflammation to obesity, diabetes, and periodontal infections. J ₂₄_. _American _Academy _of _{Periodontology.} _Parameter _on _systemic^Periodontol^{2005;76:2075-2084.}conditions affected by periodontal diseases. J Periodontol

4. Al-Zahrani MS, Bissada NF, Borawski EA. Obesity and periodontal _{2000;71:880-883.}^disease ⁱⁿ ^young, ^middle-aged, ^and ^older ^adults. ^J ^Periodontol 25. Li X, Kolltveit KM, Tronstad L, et al. Systemic diseases caused by ^{2003;74:610-615.}oral infection. Clin Microbiol Rev 2000;13:547-558.

⁵^. ^National ^{Heart, Lung, and} ^Blood ^Institute ⁱⁿ ^cooperation ^with 26. Iacopino AM. Periodontitis and diabetes interrelationships: role The National Institute of Diabetes and Digestive and Kidney _of _{inflammation.}_Ann _Periodontol _{2001;6:125-137.}

^Diseases. ^Clinical ^Guidelines ^on ^the ^{Identification,} ^Evaluation, 27. Donahue RP, Wu T. Insulin resistance and periodontal disease: An and Treatment of Overweight and Obesity in Adults. The Evidence _{epidemiologic} _overview _of _research _needs _and _future _directions.Report. NIH Publication No. 98-4083; September 1998. National _Ann _Periodontol _{2001;6:119-124.}

^Institutes ^of ^Health. 28. Singer M. AIDS and the health crisis of the US urban poor: the

⁶^. ^ADA ^Report. ^Position ^of ^the ^American ^Dietetic ^Association: perspective of critical medical anthropology. Soc Scien and Med Dietary Guidance for Healthy Children Ages 2-11. J Am Diet _{1994; 39( 7):931-48.}

^Assoc ^{2004;104:660-667.} 29. Syndemics Prevention Network: Syndemics Overview; accessed

7. GiddingSS,DennisonBA,BirchLL.,etal.Dietaryrecommendations _{http://www.cdc.gov/syndemics/overview-definition.htm}_.;for children and adolescents. A guide for practitioners. Consensus _1/31/06.

^Statement ^from ^the ^American ^Heart ^Association. ^Circulation 30. Albert DA, Kavita A, Ward A., et al. The use of academic detailing ^{2005;112:2061-2075.}to promote tobacco-use cessation counseling in dental offices.

8. The STOPP-T2D Prevention Study Group. Presence of diabetes _JADA _{2004;135:1700-1706.}risk factors in a large US eighth grade cohort. Diabetes Care 31. Druss BG, Marcus SC, Olfson M, et al. Trends in care by
^{2006;29:212-217.}non-physician clinicians in the United States. N Engl J Med
9. Lee JM, Herman WH, McPheeters ML, et al. An epidemic profile of _{2003;348:130-137.}children with diabetes in the US. Diabetes Care 2006; 29( 2):420- 32. Denver EA, Barnard M, Woolfson RG, et al. Management of
^421.uncontrolled hypertension in nurse-led clinic compared with
¹⁰^{. Bray} ^GA, ^Champagne ^C. ^Obesity ^and ^metabolic ^syndrome:conventional care for patients with type 2 diabetes. Diabetes
implications for dietetics practitioners. J Am Diet Assoc _Care_{2003;26:2256-2260.}^{2004;104:86-89.} 33. Davidson MB. Effect of nurse-directed diabetes care in a minority
11. Feig DS, Razzaq A, Sykora K, et al. Trends in deliveries, prenatal _population. _Diabetes _Care _{2003;26:2281-2287.}care, and obstetricalcomplications in women with pregestational ₃₄_{. New} _JP, _Mason _JM, _Freemantle _N, _et _{al. Specialist} _nurse-led^diabetes. ^Diabetes ^Care ^2006; ^29:232-235.intervention to treat and control hypertension and hyperlipidemia
12. Leibson CL, Burke JP, Ransom JE, et al. Relative risk of mortality _in _diabetes _(SPLINT). _Diabetes _Care _{2003;26:2250-2255.}^associated ^with ^diabetes ^as ^a ^function ^of ^birth ^weight. ^Diabetes 35. Glick M, Greenberg BL. The potential role of dentists in identifying
^Care ^2005; ^{28:2839-2843.}patients’ risk of experiencing coronary heart disease events. J
13. Bloomgarden ZT. Developments in diabetes and insulin resistance. _Am _Dent _Assoc _{2005;136:1541-1546.}

^Diabetes ^Care ^2006; ^29:161-167. 36. Ship JA. Diabetes and oral health. JADA 2003;134:4S-10S.

14. Glasgow RE. Translating research to practice. Lessons learned, areas of improvement, and future directions. Diabetes Care 2003; 26:2451-2456.

15. Saydah SH, Fradkin J, Cowie CC. Poor control of risk factors for vascular disease among adults with previously diagnosed

For additional references to this article, please consult the digital version of Grand Rounds in Oral-Systemic Medicine at www.thesystemiclink.com.