University at Buffalo researcher Mehmet A. Eskan suggests that health care providers treating individuals with type 2 diabetes (T2D) should consider checking their patients’ teeth. In a study published in PLOS ONE on April 14, Eskan demonstrated that T2D patients with good chewing function had significantly lower blood glucose levels compared to those with impaired ability to chew effectively. Eskan, a clinical assistant professor in the Department of Periodontics and Endodontics at the School of Dental Medicine at UB, conducted a retrospective study involving 94 T2D patients who had been treated at an outpatient clinic in Istanbul, Turkey. The patients were divided into two groups: the first group consisted of patients with proper occlusal function, indicating sufficient and well-placed teeth that allowed for effective chewing. This group had a blood glucose level of 7.48. The second group, comprising individuals with impaired or no chewing ability due to missing teeth, had a blood glucose level almost 2% higher at 9.42.
When you gather with loved ones at a picnic table, you may not initially think about the process of chewing. However, as you take a bite of your burger, a series of events unfolds. Chewing initiates digestion by triggering saliva production, which is essential for nutrient extraction from food.
Chewing appropriate foods provides essential nutrients, including fiber, which plays a crucial role in reducing blood glucose levels. Moreover, chewing has been found to stimulate reactions in the intestine that enhance insulin secretion, as well as in the hypothalamus, promoting a sense of satiety and reducing food intake. By consuming less, the likelihood of becoming overweight decreases, which is a significant risk factor for the development of type 2 diabetes (T2D).
Dental care and the big picture
Mehmet A. Eskan obtained his DDS from Hacettepe University, a renowned medical research center in Turkey. He further pursued his Ph.D. at the University of Louisville, where he also completed a residency in periodontology. With a focus on treating dental patients who face systemic health challenges, Eskan is dedicated to contributing to the broader goal of improving public health.
The research highlights the global impact of diabetes, with nearly half a billion people worldwide diagnosed with the condition as of 2019, and approximately 90% of those cases being type 2 diabetes (T2D).
In managing diabetes, recent approaches have recognized the significance of addressing oral health alongside promoting healthy weight maintenance, a balanced diet, and smoking cessation. Eskan emphasizes the strong correlation between mastication (chewing) and blood glucose control in T2D patients. Notably, the study found no independent variables that significantly influenced blood glucose levels among the subjects, including body mass index (BMI), gender, smoking habits, medications, or infection markers such as white blood cell count (WBC) at the baseline.
An illustrative case described in a 2020 study, co-led by Eskan, underscores the potential benefits of improving occlusal function through dental implants and appropriate fixed restorations. The study focused on a T2D patient with severely impaired chewing ability due to missing teeth, initially presenting with a blood glucose level of 9.1. The patient relied on a bottle and baby food for nutrition. Following treatment with a full mouth implant-supported fixed restoration, the patient’s glucose level decreased to 7.8 after four months and further dropped to 6.2 after 18 months. This outcome demonstrates the dramatic improvement achieved through the restoration of proper chewing function.
According to Eskan, research has indicated that even a small increase of 1% in blood glucose levels can lead to a significant 40% rise in mortality from cardiovascular or ischemic heart disease among individuals with diabetes. Additionally, complications associated with diabetes include kidney disease, eye damage, neuropathy, and impaired wound healing for minor injuries like cuts and blisters.
Eskan’s primary focus lies in conducting research that can have a tangible impact on people’s health in the present. Collaborating with co-author Yeter E. Bayram, MD, from the Department of Internal Medicine at Hamidiye Sisli Etfal Education and Research Hospital in Istanbul, Eskan anticipates further studies that will delve into potential causal relationships between occlusal support (chewing function) and blood glucose levels. These investigations aim to shed light on the underlying mechanisms and provide insights into how improving chewing ability may positively affect blood glucose control in individuals with diabetes.
Source: University at Buffalo