Background and Objectives: Periodontitis and Diabetes Mellitus are both inflammatory conditions that trigger the host response in a similar manner. The effect of uncontrolled diabetes on the progression of periodontitis, as well as the effect of periodontal health on the glycemic control of a patient, have been well documented. The need to include oral health in the management of a diabetic patient is deemed necessary. The objective of this study is to determine the awareness of the interrelationship between diabetes and periodontal disease among Endocrinologists in the Philippines and to determine whether management of a diabetic patient includes measures on maintaining periodontal health. Methodology: A 20-item self-administered survey questionnaire was distributed to endocrinologists registered in the Philippine Society of Endocrinology, Diabetes and Metabolism (PSEDM) Seminar and General Assembly held on September 5-6, 2015 at Sofitel Manila, Pasay City. The questionnaire was comprised of eight multiple choice and 12 yes-no questions, which combined queries on demographics, associations between diabetes and periodontitis as well as patient management. Results: Most of the endocrinologists answered that tooth brushing and flossing should be performed at a minimum of twice a day (96.6%) and that frequency of dental visits should be at least every six months (71.3%). Although most endocrinologists claimed to be aware of the manifestations of gingivitis and periodontitis, only 3.6% accurately identified the symptoms of gingivitis and 3% accurately identified the symptoms of periodontitis. Majority (79.2%) were aware that periodontal disease affects Diabetes Mellitus (DM) and that DM is a risk factor for Periodontitis (95.9%). However, only 38.6% noted periodontitis as one of the complications of diabetes. More than half of the respondents refer their patients to dentists but less than half educate their patients on oral health. Conclusion More than 90% of the Endocrinologists are aware of the bidirectional relationship of Periodontal disease and diabetes mellitus but do not clearly know the difference between gingivitis and periodontitis. In addition, the awareness is not translated to the management of diabetic patients.
Endocrinologists ; Periodontal Diseases

OBJECTIVE: Diabetes in pregnancy is associated with maternal and fetal risks that include maternal hyperglycemia and neonatal hypoglycemia. Intrapartal plasma glucose concentration has a stronger association with decreased neonatal hypoglycemia paralleled with antepartum plasma glucose levels. The objective of the study is to determine the association between intrapartal glucose monitoring and neonatal hypoglycemia.

METHODS: This is a retrospective cohort study that involves parturients of any age with term gestation (>37 weeks) with gestational type or overt type of diabetes mellitus, either insulin-requiring or on medical nutrition therapy, with or without mean capillary blood glucose levels during labor. Multiple logistic regression was used for analysis, which quantifies the magnitude of association between maternal blood glucose control and neonatal hypoglycemia adjusted for significant confounders.

RESULTS: The incidence of diabetes among pregnants in this private tertiary hospital over the study period was 7.82%. Most of the diabetic parturients were primigravid, with gestational type of diabetes mellitus, and on medical nutrition therapy. More than half were referred to an endocrinologist intrapartum. The incidence of maternal hyperglycemia intrapartum is 33%. The birthweights of the neonates ranged from 2095 to 5250 grams. Among the diabetic parturients, the incidence of neonatal hypoglycemia is 10%. There was no significant association between neonatal hypoglycemia and intrapartummaternal hyperglycemia (p=0.05).

CONCLUSION: There is no significant association between intrapartum maternal hyperglycemia and development of neonatal hypoglycemia. Antepartum and intrapartum management of maternal hyperglycemia did not appear to be associated with the development of neonatal hypoglycemia. A standardized institutional management protocol on glucose monitoring and control among diabetic parturients is strongly suggested.

Human ; Female ; Adult ; Pregnancy ; Insulin ; Blood Glucose ; Endocrinologists ; Hyperglycemia ; Hypoglycemia ; Birth Weight ; Gravidity ; Nutrition Therapy