Laboratorio de Modelamiento en Medicina, Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile.
Clinical Studies Unit, Escuela de Medicina, Universidad de Valparaíso, Valparaíso, Chile.
Front Public Health. 2023 Dec 21;11:1270557. doi: 10.3389/fpubh.2023.1270557. eCollection 2023.
Type 2 diabetes and its associated cardiovascular risk is an escalating epidemic that represents a significant public health burden due to increased morbidity and mortality, disproportionately affecting disadvantaged communities. Poor glycaemic control exacerbates this burden by increasing retinal, renal, and cardiac damage and raising healthcare costs. This predicament underscores the urgent need for research into cost-effective approaches to preventing diabetes complications. An important but often overlooked strategy to improve metabolic control in diabetic patients is the treatment of periodontitis. Our aim is to assess whether the inclusion of periodontitis treatment in diabetes management strategies can effectively improve metabolic control, and to advocate for its inclusion from an equity perspective. We conducted a comprehensive review of the literature from 2000 to 2023. We analyzed the pathophysiological links between periodontitis, diabetes, and atherosclerotic cardiovascular disease, all of which have inflammation as a central component. We also examined the inequalities in health care spending in this context. Our findings suggest that incorporating routine screening and treatment of periodontitis into national health programs, with coordinated efforts between physicians and dentists, is a cost-effective measure to improve metabolic control, reduce complications and improve the overall quality of life of people with diabetes.
2 型糖尿病及其相关心血管风险是一种不断加剧的流行疾病，由于发病率和死亡率的增加，给公共卫生带来了巨大负担，而且不成比例地影响到贫困社区。由于视网膜、肾脏和心脏损伤的增加以及医疗保健成本的提高，血糖控制不佳使这种负担进一步恶化。这种困境突显了迫切需要研究预防糖尿病并发症的具有成本效益的方法。改善糖尿病患者代谢控制的一个重要但经常被忽视的策略是治疗牙周炎。我们的目的是评估在糖尿病管理策略中纳入牙周炎治疗是否能有效改善代谢控制，并从公平的角度为其纳入提供依据。我们对 2000 年至 2023 年的文献进行了全面综述。我们分析了牙周炎、糖尿病和动脉粥样硬化性心血管疾病之间的病理生理联系，所有这些疾病都以炎症为核心组成部分。我们还研究了在这种情况下医疗保健支出的不平等现象。我们的研究结果表明，将牙周炎的常规筛查和治疗纳入国家卫生计划，并协调医生和牙医的努力，是改善代谢控制、减少并发症和提高糖尿病患者整体生活质量的一种具有成本效益的措施。
