Diabetic Microagiopathy of Oral Mucosa Depends on Disease Duration and Therapy

Abstract

BackgroundDiabetes mellitus is a chronic degenerative systemic disease whose prevalence is increasing. This paper aims to evaluate the effects of diabetic microangiopathy, depending on its duration and the type of treatment administered, by using polarized light videocapillaroscopy of the oral mucosa.Material/MethodsWe enrolled 120 subjects: 60 healthy subjects and 60 patients with diabetes mellitus. In turn, patients were divided into 3 subgroups according to the type of diabetes, the duration of the disease, and the type of treatment administered. A videocapillaroscopic examination of the oral mucosa was carried out on the diabetic and healthy subjects.ResultsChanges in microcirculation were detected in diabetic patients: at the level of the labial, buccal, and lingual mucosa, the density of the loops is on average reduced; there is an increase in the length and the total diameter of the loops, while the average density of the periodontal capillaries is much higher. The most significant changes were noted in patients who had had type 1 diabetes for more than 10 years and had received insulin therapy.ConclusionsThis study, performed using polarized light videocapillaroscopy, which for the first time was used to analyze the capillaries of the oral mucosa in patients with diabetes, confirms the presence of changes that are instrumentally “objectifiable” and “quantifiable” through the videocapillaroscopic technique. Videocapillaroscopy can be a reliable method in the study and monitoring of complications in patients with type 1 and 2 diabetes mellitus.

Risk Factors of Pulmonary Tuberculosis Among Diabetes Mellitus Patients: A Case-Control Study in Dr. Kariadi General Hospital, Semarang, Indonesia

“…The immunity of the DM patient is more compromised, particularly for long duration DM as a result of micro-and macro-vascular complications as well as the treatment tolerance of the disease 28 . Indeed much is known about the duration of the DM implying the complication and severity of the diseases as well as the terminal outcome, either in the general complication or especially in the TB occurrence [29][30][31] .The present study did not provide evidence of a longer duration of DM as a risk factor for pulmonary TB, because of the interaction of household contact (OR=63.3) as the most influential factor. In this study, the proportion of shorter duration of DM was higher in the subjects with household contact group compared to the negative contact group (Figure 2).…”

Videocapillaroscopy of the Oral Mucosa in Patients with Diabetic Foot: Possible Diagnostic Role of Microangiopathic Damage?

“…In the event that microangiopathy is generalized, an important contribution can be ascribed to the study of peripheral microcirculation and therefore also to the study of oral microcirculation [ 22 , 23 , 24 ].…”

“…The oral mucosa, in fact, has many advantages compared to other sites (periungual fold, conjunctival mucosa, dermis) [ 13 , 22 , 23 , 24 , 25 ].…”

Type 1 Diabetes and Periodontal Health

“…26 The structural alterations in microvasculature may be detected with available imaging methods. Scardina et al 27 in polarized light videocapillaroscopy revealed microangiopathic changes in oral mucosa in patients with T1D and T2D, which included reduced density and altered length and diameter of the loops and increased density of the periodontal capillaries. The most significant changes were noted in patients with T1D and correlated with disease duration.…”

“…The most significant changes were noted in patients with T1D and correlated with disease duration. 27 Recent studies found the associations of periodontal disease with microvascular complications of diabetes. The significant association between diameters of retinal venules and severe periodontitis was found in patients with diabetes, but not in patients with severe periodontitis and no diabetes.…”