Managing Diabetes: The Oral-Vision Connection
Many are aware of serious diabetes-related complications such as heart disease, nerve damage, and limb amputation. However, people may not be aware of how diabetes can affect oral and visual health.
November is National Diabetes Month, and primary care physicians, dentists and eye-care specialists are urging people to schedule regular checkups. For people with diabetes, these visits can help regulate the disease’s impact on dental, visual and overall health. For people who are not aware that they might have diabetes, certain signs and symptoms can help diagnose the disease.
According to the Centers for Disease Control and Prevention (CDC), one-quarter of the 26 million Americans with diabetes, and 90 percent of the 79 million adults with prediabetes, are unaware of their condition.
“There are many people who do not know that they have diabetes, or are at risk for developing diabetes, and this puts a premium on diagnosis. The eyes and mouth can be a window into your health,” says Michael D. Weitzner, DMD, MS, vice president of National Clinical Operations for UnitedHealthcare’s dental business.
Periodontal disease, an infection that affects the gum tissue and bone that hold one’s teeth in place and can lead to bad breath, abscesses and tooth loss, may be a first indicator that a person may not have control of his or her blood sugar level.
“Diabetes has the potential of weakening one’s ability to fight bacteria in the mouth and throughout the body. Unmanaged blood sugar can lead to difficulty fighting infection appropriately, paving the way for serious gum disease,” said John Luther, DMD, MS, chief dental officer at UnitedHealthcare. “Because periodontal disease is often painless, people may not know they have it until the damage has already been done.”
Diabetes also makes people more prone to other dental problems, including oral infections, thrush and dry mouth. Dr. Luther recommends diabetes patients: schedule dental checkups every six months and alert their dentists that they have diabetes; make sure to take normal medications prior to dental visits unless your dentist or doctor instructs otherwise; and maintain an oral health care regimen of regular and rigorous flossing and brushing using toothpaste with an antiplaque or antibacterial ingredient and preferably with an electric toothbrush.
The relationship between diabetes and visual health is also significant.
“Eye examinations play a significant role in diagnosing, monitoring and managing diabetes,” said Linda Chous, O.D., chief eye care officer at UnitedHealthcare. “According to the CDC, recent studies show that keeping one’s blood glucose levels close to normal can help prevent or delay the onset of diabetes-related eye disease.”
Diabetic retinopathy, which occurs when the disease damages the tiny blood vessels that nourish the retina, is the leading cause of blindness in the United States among people between 20 and 74 years’ old. People with either type 1 or type 2 diabetes are at risk of developing diabetic retinopathy; the National Eye Institute estimates that between 40 and 45 percent of Americans diagnosed with diabetes have some form of retinopathy. Vision complications related to diabetes extend beyond retinopathy to include increased risk of developing glaucoma and cataracts.
“All patients with diabetes should receive a comprehensive dilated eye exam at least once a year,” Dr. Chous said. “Equally important, the dilated eye exam can help detect diabetes in those unaware that they have the condition. Oftentimes a patient will come in for a routine exam and the eye doctor will find evidence that the patient is at risk for diabetes or might in fact already be diabetic and will refer that patient to his/her primary care physician for further testing.”
Since there are often no outward signs or pain associated with the early stages of diabetes, changes in vision such as blurriness, seeing spots or persistent redness can be symptomatic of the disease.
“Sudden shifts in blood sugar can cause changes in the eye lens that can lead to fluctuations in a person’s eyeglass or contact lens prescription,” Dr. Chous said. Other vision-related complications of diabetes that can serve as early indicators of the disease include double vision, dry eyes and lid infection.
“People with diabetes have special health considerations,” Weitzner said. “This National Diabetes Month, don’t forget to make dental and visual care a priority.”