Rapid periodontal destruction in adult humans with poorly controlled diabetes. A report of 2 cases.

Out of a pool of 12 middle-aged or elderly diabetic patients demonstrating rapid periodontal break-down, the 2 oldest cases with follow-up periods of 19 and 16 years are described. The common feature of all 12 patients was that they were either unaware of or unable to control their diabetic condition at the time of the active stage of their periodontal disease. The bone loss progressed in spite of specialist periodontal care and the patients again responded to treatment only after their elevated blood glucose levels had been brought back to normal. Thus, the rapid periodontal breakdown was not found to be associated with the diabetic condition per se, but rather with the hyperglycemia. This clinical follow-up study does not answer the question of whether rapid periodontal destruction occurs in all patients with poorly controlled diabetes. Neither do the observations imply that rapid bone loss would be pathognomic of high blood glucose levels. However, the observations seem to suggest that there may be an inter-relationship between rapid periodontal breakdown and elevated blood glucose levels. Therefore, any sudden change towards an increased progression rate of periodontal breakdown at adult age, as observed from periodic radiographs with intervals of only a few years, should be followed up with a medical examination in order to outrule or verify the possibility of a high blood glucose level.