Diabetes Mellitus

Article written by 

Dr. Neha Rai 
MBBS, MD SR AIIMS Patna

Diabetes Mellitus refers to a group of common metabolic disorders that share the phenotype of hyperglycaemia and are caused by a complex interaction of genetics and environmental factors. It is very different from Diabetes Insipidus. Diabetes Insipidus is a syndrome characterised by the production of abnormally large volumes of dilute urine due to decreased secretion or action of Vasopressin, a hormone secreted by the posterior pituitary gland. 

The pathogenic process leading to hyperglycaemia is the basis for classification of diabetes mellitus into several types. Age or insulin dependence are no longer the criteria for differentiation. Type I and Type II are the two broad categories. In Type I DM there is destruction of pancreatic β cells and insulin deficiency resulting from autoimmune β cell destruction. Type II DM is characterised by variable degree of insulin resistance, impaired insulin secretion, excessive hepatic glucose production and abnormal fat metabolism. 

Effects of Diabetes Mellitus on Osseointegration and Dental Implants

Effect of Diabetes on Osseointegration and Dental Implants

The tenacious hyperglycaemia in diabetic people, hinder osteoblastic activity and modifies the response of parathyroid hormone that adjusts metabolism of Ca and P, decreases collagen synthesis during callus formation, induces apoptosis in lining cells of bone and increases osteoclastic activity due to untiring inflammatory response. It also stimulates deleterious effect on bone matrix and reduces growth and build-up of extracellular matrix. The subsequent result is reduced bone formation during healing.

Type -1 diabetes (insulin dependent) causes decreased bone formation, as well as reduced bone mineral density and higher bone resorption while Type -2 diabetes (non-insulin dependent) produces normal or greater bone mineral density in some patients. It has been detected that insulin not only diminishes the harmful effect of hyperglycaemia by controlling it but also stimulates osteoblastic activity.