Foundations in Continuing Education

The Dental Patient with Diabetes

Chapter Four - Diabetes Mellitus Type 2


Chapter 1: Glucose Metabolism and Hormonal Regulation Review

Chapter 2: Diabetes Mellitus

Chapter 3: Diabetes Mellitus Type 1

Introduction
Etiology (Risk Factors)
Pathophysiology
Epidemiology

Chapter 5: Gestational Diabetes Mellitus (GDM)

Chapter 6: Pre Diabetes: Impaired Glucose Homeostasis

Chapter 7: Other Specific Types of Diabetes

Chapter 8: Diagnosing Diabetes

Chapter 9: Diagnosis

Chapter 10: Glucose Monitoring

Chapter 11: Complications of Diabetes

Chapter 12: The Dental Patient with Diabetes

Chapter 13: Successful Intervention of Diabetic Emergencies

Chapter 14: Prevention and Treatment of DM

Chapter 15: Diabetes Medications

Chapter 16: Conclusion

Glossary

Appendices

References

Post Examination

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Etiology (Risk Factors)

Family History/Genetic Risk

An individual with a family member diagnosed with Type 2 is at greater risk for developing diabetes himself or herself. If an individual is diagnosed by the age of 50 with Type 2 their offspring's risk is around 15%; after the age of 50 it is around 8%. The risk is greater if the mother has Type 2. If both parents have a Type 2 diagnosis the risk to offspring is 50%. (3,15,31)

"As many as 20%-60% of people in the general population may be genetically susceptible to Type 2 diabetes." (30) Several "candidate genes" have been discovered and linked to the inheritance of Type 2. As yet, there appears to be no clear understanding of the way an individual "inherits" diabetes.

Age

As we age, we are more at risk for developing Type 2. The risk increases dramatically after the age of 40. Specifically, those aged 65-74 years are at highest risk. However, onset of Type 2 under the age of 30 is becoming more common. High-risk groups are more likely to develop Type 2 at an earlier age. (31)

Gender

There is no significant difference related to gender. (3)

Race/Ethnicity & Geographic Distribution

Risk for developing Type 2 is higher for:

  • Native Americans
  • Pacific Islanders
  • African-Americans
  • Hispanics
  • Asian Americans

Type 2 is strongly linked to western cultures. When there is a high genetic risk for onset, individuals living in non-westernized cultures are less likely to develop Type 2. (3,4,21,31)

Obesity

Considered a strong risk factor, obesity places many at risk. Location of body fat (abdominal) and duration of obesity are believed to be significant in increasing risk. The combination of obesity and a family history of diabetes are considered to greatly increase the incidence of Type 2. (3,31)

Other Risk Factors

  • Diet-Mostly believed to be related to total calorie intake versus the individual components of food.

  • Physical Activity-Because higher insulin activity is associated with physical activity, those with active lifestyles are less likely to develop Type 2. (3)

Continue on to Pathophysiology