A new study finds twice daily mouthwash use increased risk of pre-diabetes and diabetes by 55%.
Researchers reviewed the data of 948 individuals who were either obese or overweight, apart of the San Juan Overweight Adults Longitudinal Study in Puerto Rico, and found over the three-year follow-up:
- Participants who used mouthwash at least twice daily had 55 percent significantly increased risk of developing pre-diabetes or diabetes over a 3-year follow-up compared to less frequent users, and 49 percent higher risk compared to non-users of mouthwash
- 30% of those studied developed either pre-diabetes or diabetes by the end of the period.
Now according to the study, 65% of those enrolled had poor dental health, so they might have been more inclined to using the mouthwash. And since diabetes is a risk factor for periodontal disease, it’s no surprise that those with poor gums and teeth, due to diet and/or poor circulation, would be more at risk for diabetes.
Many use mouthwash to fight germs and plaque, freshen breath, and with fluoride to prevent cavities. However, it does not replace bushing and flossing and its use should only complement good dental hygiene.
So why would mouthwash use increase diabetes risk?
Even though this study only found an association with those who mouthwash frequently and diabetes risk, the following could contribute to this finding:
- Many sugary foods cause gum and tooth disease, hence those needing mouthwash more frequently may have poor diet choices.
- High fat foods and eating large quantities, habits that contribute to diabetes, may leave one with frequent GERD, gastroesophageal reflux disease, which causes bad breath.
- Mouthwash may kill some of the good bacteria that help protect against obesity and diabetes.
A review of diabetes
Diabetes is a disease in which the body doesn’t utilize and metabolize sugar properly. When we consume food, its broken down into proteins, nutrients, fats, water, and sugar. These components are necessary for cell growth and function. They get absorbed in the small intestine and make it to the blood stream. In order for a cell to utilize sugar, it needs the hormone insulin to help guide it in. It’s similar to a key that fits in the keyhole of the “door” of the cell, opening it up so sugar can enter. Insulin is produced in the pancreas, an organ that receives signals when one eats to release insulin in preparation of the sugar load coming down the pike.
So I imagine our mouth like a waiting room, the blood stream like a hallway, and the cells of the body the rooms along the hallway. Insulin is the key to open the cells’ “doors” allowing sugar to enter. If the sugar does not get in, it stays in the bloodstream “hallway” and doesn’t feed the cell. Weight loss occurs, and individuals may become more thirsty as the sugar in the blood makes it fairly osmotic, something the body wants to neutralize, reduce. The kidneys are going to want dump the excess sugar, so to do so, one would urinate more, again causing thirst. So when a diabetic loses weight, urinates more frequently and becomes thirsty, you now understand why.
Type I vs. Type II vs. Type IIIc Diabetes
Type I Diabetes, previously called insulin dependent or Juvenile diabetes, occurs when the pancreas doesn’t produce insulin, possibly from the immune system destroying the cells that produce the hormone. When this occurs there is rapid weight loss and death could occur if the cells don’t get the sugar they need. Insulin has to be administered regularly.
Type II Diabetes, previously called non-insulin dependent or adult-onset diabetes, occurs in those who began with a fully functioning pancreas but as they age the pancreas produces less insulin, called insulin deficiency, or the insulin produced meets resistance. This is the fastest growing type of diabetes in both children and adults.
Type IIIc diabetes may occur in individuals who suffered damage to their pancreas. Inflammation/infection of the pancreas (pancreatitis), a pancreatic tumor, or surgery affecting the pancreas may destroy the beta cells that produce insulin.
Complications of Diabetes
Cardiovascular disease – Sugar is sticky, so it can easily add to atherosclerotic plaques.
Blindness – high sugar content draws in water to neutralize and small blood vessels in the eye can only take so much fluid before they burst. Moreover, high blood sugar weakens blood vessels.
Kidney disease – the kidneys work overtime to eliminate the excess sugar. Moreover, sugar laden blood isn’t the healthiest when they themselves need nourishment.
Infections – pathogens love sugar. Its food for them. Moreover blood laden with sugar doesn’t allow immune cells to work in the most opportune environment.
Neuropathy – nerves don’t receive adequate blood supply due to the diabetes-damaged blood flow and vessels, hence they become dull or hypersensitive causing diabetics to have numbness or pain.
Dementia – as with the heart and other organs, the brain needs healthy blood and flow. Diabetes has been found to increase risk of Alzheimer’s as well.
What is insulin resistance?
Insulin resistance, if using our hallway and door analogy, is as if someone is pushing against the door the insulin is trying to unlock. As we know, those with obesity are at higher risk for diabetes, hence fat can increase insulin resistance. It’s also been associated with an increase in heart disease.
Blood sugar numbers
If your fasting blood sugar (glucose) is greater than 126 mg/dl, or your non fasting blood sugar is greater than 200 mg/dl, you may be considered diabetic. Pre-diabetes occurs when the fasting blood sugar is between 100 and 125 mg/dl. If ignored, and the sugar rises, pre-diabetics may go on to develop diabetes.
1/3 of American adults are currently pre-diabetic. Experts predict 1/3 of US Adults will be diabetic by the year 2050. Although genetics plays a big role, decreasing ones sugar intake and maintaining an active lifestyle can help ward of diabetes.
Foods high in sugar and carbohydrates increase one’s risk, so a diet rich in vegetables and lean meats is preferred.
Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, iHeart Radio and Board Certified Family Physician