Dysphagia Symptoms In People With Diabetes: A Preliminary Report

BACKGROUND: Diabetes mellitus is a systemic disease affecting whole-body functioning. The underlying mechanisms and associated concomitant conditions suggest an increased risk for the occurrence of oropharyngeal dysphagia. PURPOSE: This is a qualitative study designed to assess perception of symptoms of oropharyngeal dysphagia in people with diabetes. METHODS: Participants were recruited by word-of-mouth and asked to complete a survey by answering questions on a Likert-type scale indicating the frequency with which they experience each symptom. Responses were weighted and analyzed according to frequency, providing a percentage of responses in each dysphagia category. Symptoms of dysphagia were examined in an overall manner, and by the following variables: age, ethnicity, duration of diagnosis, presence of oral phase difficulty, management of diabetes, and oral health. RESULTS: Overall, people with diabetes do report a variety of symptoms of swallowing problems. The proportion of dysphagia symptoms appears to be greater among older individuals, individuals with type 2 diabetes, those who have been diagnosed for less than 50% of their lives, and those with poorer oral health. CONCLUSIONS: People with diabetes indicate symptoms of oropharyngeal dysphagia on this self-report survey. Future studies would benefit from the inclusion of an objective swallow assessment following up on these reports. Keywords: diabetes, dysphagia, cognition, oral health, diabetic cough, cough reflex threshold, vagus nerve, diabetic neuropathy, autonomic neuropath

An Assessment of a Video on the Link Between Diabetes and Peridontal Disease to Educate Native American Populations.

As the Native American population of the Navajo Nation, becomes affected with diabetes dental offices across the Navajo Reservation must ensure that evidence based research is being presented n the oral systemic link of diabetes and periodontal disease. The purpose of this study was to bring awareness to the important topic of the bi-directional link of diabetes and periodontal disease with Native American dental patients. This topic seems to not be valued during oral hygiene education time and so that addition of a culturally-specific educational video on the topic should add value to the message. This topic was investigated via survey instrument and data were collected from three New Mexico Dental Hygiene Programs. Results of this study reinforced the importance of this video being added to the standard protocol dental visit, it illustrated the impact that this educational initiative could have on this population. A reinforcement of including this video during dental visits improves the awareness of the oral systemic connection

Oral health and nutritional characteristics of adults with morbid obesity: a multivariate analysis.

The relationship between oral health and nutritional aspects are complex, especially in individuals with chronic diseases and comorbidities, such as morbid obesity. Thus, the aim of the present study was to identify oral health and nutritional-related patterns in 113 individuals, aged 19–68 years (92 females), seeking treatment for morbid obesity. Sociodemographic variables and medical records were examined, in addition to the consumption of fruit, vegetables, candies, and processed foods. Measures of body mass index, neck, waist and hip, caries experience (DMFT index), Community Periodontal Index (CPI index), and salivary physicochemical aspects were gathered. Aspects of oral health-related quality of life and symptoms of dry mouth were evaluated by means of Oral Health Impact Profile (OHIP-14) and Xerostomia Inventory-XI questionnaires. K-means cluster analysis and, subsequently, comparisons between clusters (one-way ANOVA) were performed (α = 5%). Three clusters were generated: Cluster 1 (labeled “Young”; n = 77) was characterized by younger participants with higher BMI, who reported the use of distractors while eating, the smallest number of meals/day, and who consumed sweetened drinks and processed food the day before. Cluster 2 (labeled “Diabetic individuals”; n = 12) was characterized by older participants with the highest proportion of diabetic participants (100% were diabetic; 73% insulin users), lower BMI, higher DMFT index and OHIP-14 and xerostomia scores, and who reported having consumed fruit and vegetables the day before. Finally, Cluster 3 (labeled “Poor periodontal health”; n = 24) was characterized by participants with the worse periodontal condition (higher CPI), and lower salivary flow, pH, and buffer capacity. Cluster 1 and 2 were the groups that showed higher demand for nutritional and dietetic counseling, because of the poor eating behavior and higher serum glucose levels, respectively. On the other hand, Cluster 2 and 3 showed the higher demand for oral rehabilitation and dental treatment because of the loss of teeth and worse periodontal condition, respectively, besides the need for dietetic counseling. This sample of individuals with morbid obesity showed very unique oral-health and nutritional characteristics and special needs patterns that should be identified to adjust or change unhealthy habits, thus improving the assistance of this condition