DentalCare Logo

Aging, Systemic Disease and Oral Health: Implications for Women Worldwide (Part I)

Course Number: 302


Diabetes is a disease occurring when the pancreas produces an inadequate amount of insulin or when insulin is improperly used by the cells, thus, leaving the body incapable of breaking down carbohydrates and starches into energy. Insulin, an important hormone, is used to regulate blood sugar. An increase in the amount of blood sugar is known as hyperglycemia, which is a common reaction from uncontrolled diabetes over a period of time. Many of the body’s systems such as the heart, eyes, kidneys, oral cavity, nerves, and blood vessels can become damaged due to uncontrolled diabetic conditions.

People with Type 1 diabetes produce little or no insulin and represent about 5% of those diagnosed with the disease. It is essential that people with Type 1 diabetes receive insulin daily. Without insulin, you cannot convert food into usable energy. Without insulin, a person with Type 1 diabetes cannot survive.42 About 90% of those with diabetes globally have Type 2 diabetes, which is largely due to excessive body weight and inactive or limited physical activity. Those with Type 2 produce insufficient amounts of insulin or the body uses what is produced improperly. Oftentimes, the disease is diagnosed years after symptoms have been identified and serious complications have already developed. According to the WHO, in 2014, 8.5% of adults aged 18 years and older had diabetes. In 2019, diabetes was the direct cause of 1.5 million deaths and 48% of all deaths due to diabetes occurred before the age of 70 years.43 Nearly 10 percent of pregnancies in the U.S. are affected by gestational diabetes mellitus (GDM) every year. It has been well documented that women found to have GDM are at high risk for development of type 2 diabetes mellitus in subsequent years.44

The Centers for Disease Control and Prevention have reported diabetes as the seventh leading cause of death among American women and the fourth leading cause of death among Hispanic and African-American women.45 Diabetes increases the risk of heart disease by about four times in women, but only about two times in men, and women have worse outcomes after a heart attack. Women are also at higher risk of other diabetes-related complications such as blindness, kidney disease, Alzheimer's disease, and depression.46 If blood glucose levels can be controlled, the risk of a CVD event, stroke, heart attack or death from CVD can be reduced.41 Many people do not even know they have diabetes. In fact, of the 29.1 million American adults who have the disease, it is estimated that 1 out of 4 are unaware of their diagnosis.47

The global diabetes prevalence in 2019 was estimated to be 9.3% (463 million people), rising to 10.2% (578 million) by 2030 and 10.9% (700 million) by 2045.48 The reasons for this increase are complex and the International Diabetes Federation (IDF) Diabetes Atlas data cannot estimate their various contributions but they include: increasing incidence of Type 1 diabetes in children, especially younger children; increasing incidence of Type 2 diabetes in young people and increasing incidence of Type 2 diabetes in adults as a result of sedentary living, high-energy dietary intakes and other as yet unknown factors; the inter-generational effects of hyperglycemia in pregnancy and the general ageing of the global population. Conversely, earlier diagnosis of Type 2 and better management of all types of diabetes leading to greater life-expectancy are also contributing to this rise in prevalence.48

Significant economic burdens are placed on families, individuals, countries, and healthcare systems due to diabetes and its numerous complications. Countries in the Western world report those with Type 2 diabetes frequently experience kidney disease, which has exorbitant costs associated with dialysis.48