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Diabetes, Oral Health and Nutrition: Inter-relationships, Innovations and Interaction On September 20th, 2013, for the second consecutive year the link between diabetes and oral health has been investigated in an international seminar in Europe under the auspices of the Joslin Sunstar Diabetes Education Initiative (JSDEI), bringing a unique interdisciplinary approach to diabetes – a metabolic disease affecting millions of people across the world. This symposium in Milan, Italy, welcomed Diabetologists, Endocrinologists, Periodontists, Dentists, Dental Hygienists, Nutritionists and post-graduate students from all over Europe with an engaging scientific programme. Consisting of an audience of approximately 300 international experts, the speakers of the symposium ‘Diabetes, Oral Health & Nutrition: Inter-relationships, Innovations & Interaction’ reiterated the issue of diabetes, underlining the importance of several inter-related factors that must be considered in order to decrease the risk of diabetic complications. The symposium was organised by the Sunstar Foundation (Japan) and the Joslin Diabetes Center (USA), the world’s pre-eminent diabetes research and clinical care organization with the support of Sunstar and the partnership with the FDI (World Dental Federation). Accreditation support was provided by the SIdP (Italian Society of Periodontology), AIDI (Italian Dental Hygienists Association) and SID (Italian Society of Diabetology). As highlighted by the speakers, the starting point of an interdisciplinary approach is the awareness of the connection between diabetes and periodontitis. Actually, periodontitis has been linked with worsening glycaemic control in people with diabetes as well as with increased risk for diabetic complications including coronary artery disease (CAD), renal disease, and increased mortality. On the other hand, periodontal disease is an infectious complication of diabetes. Consequently, in case of poorly controlled diabetes, the patient will be at a greater risk for severe periodontal disease. Therefore, it is of paramount importance to develop practical screening strategies in order to treat patients from the different perspectives. According to the lecture of Robert J. Genco, Distinguished Professor of Oral Biology and Microbiology at the State University of New York at Buffalo, ‘Current Understanding of the Association Between Periodontal Disease and Diabetes Mellitus’, the treatment of periodontal disease in patients can improve glycaemic control, possibly by improving insulin sensitivity. Consequently, it is fundamental to include management of periodontal disease in the complete care of patients with diabetes. Development of hyperglycaemia in type 2 diabetes is the result of the concomitance of predisposing, precipitating, and accelerating factors, and the mechanisms of diabetic complications are complex and related to periodontal diseases. This is what emerged from the presentations by George L. King, Professor of Medicine at the Harvard Medical School and Director of Research, Joslin Diabetes Center, Boston, ‘Mechanisms of Diabetic Complications: Role of insulin resistance and hyperglycaemia’, and by Stephano Del Prato, Professor of Endocrinology at the University of Pisa, Italy, ‘The pathogenetic complexity of type 2 diabetes’. From the symposium it was evident that genetic background plus an environment with calorically dense food and sedentary lifestyle have led to worldwide epidemics of type 2 diabetes and obesity. C. Ronald Kahn of the Joslin Diabetes Center, Livio Luzi, Professor of Endocrinology at the University of Milan and Maurizio Tonetti, Executive Director, European Research Group on Periodontology (ERGOPerio) investigated the interplay between lifestyle, insulin resistance and periodontal diseases, and stressed the importance of correct nutrition and physical activity in order to decrease insulin resistance and hyperglycaemia. High fat, high glycemic index and low anti-oxidant content diets impair insulin action. On the contrary, positive lifestyle changes have an immune-modulation effect, activating intracellular signaling pathways and leading to improvement of insulin resistance. In conclusion, as periodontitis in poorly controlled diabetics can lead to severe complications, it is necessary that periodontists, dentists and dental hygienists are involved in treating diabetic patients together with the diabetologist, nutritionist and the general medical practitioner to complete the multidisciplinary approach in modern day patient management. In this context, dental specialists must not only treat periodontal diseases, but also inform patients about the importance of nutrition, weight reduction and physical activity. Moreover, they must play a specific role in identifying patients who are at risk for diabetes because a dental referral to a physician could provide an opportunity to contribute to early diagnosis and early intervention. About Sunstar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www.sunstar.com www.sunstargum.com


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British Society of Periodontology BSP Autumn Scientific meeting The root of the problem! Royal College of Surgeons London United Kingdom BSP Autumn scientific meetingOne day meeting

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German Society of Periodontology Modul 2 of the German Spring meeting University of ZĂźrich (Switzerland) Germany

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Italian Society of Periodontology and Implantology XVIII National Congress Quality and safety in periodontal and implant surgery Palacongressi di Rimini Via della Fiera 23 47923 Rimini Italy

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Dutch Society of Periodontology NVvP voorjaarscongres 2014 Go easy on pink: soft tissues managed?! CineMec in Ede-Wageningen Netherlands

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Dutch Society of Periodontology Najaarscongres NVvP @Risk Jaarbeurs Utrecht, Beatrixtheater Utrecht Netherlands

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Spanish Society of Periodontology and Osseointegration 48Âş SEPA Annual meeting Multdisciplinar Periodontology Valladolid Spain

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Swiss Society of Periodontology SSP 44. Jahrestagung 2014 ZĂźrich Switzerland






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EFP News Vol 18 No 1 October 2013  

The Newsletter of the European Federation of Periodontology

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