Diabetes mellitus

Diabetes Mellitus is a chronic metabolic disorder caused by the deficiency of the pancreatic hormone insulin (Type 1 DM) or due to the resistance of the peripheral cells to the insulin secreted by pancreatic β cells(Type 2 DM). It is characterized by chronic hyperglycaemia. The patients are associated with symptoms like polyuria, polydipsia and polyphagia.Type I Diabetes is normally controlled by diet restriction, exercise and insulin therapy. Type II Diabetes is treated with various oral hypoglycaemic agents in addition to dietary restriction and exercise. In severe cases exogenous supply of insulin is also used for therapy. Periodontitis is considered to be the 6th complication of diabetes mellitus. It is a group of inflammatory diseases affecting the supporting structures that surround the tooth. It causes inflammation of gum, loss of alveolar bone and destruction of periodontal ligament. Maintaining oral hygiene is the first step in controlling periodontitis. Chlorhexidine or listerine mouthwash is used commonly. The antibiotic of choice for the treatment is Doxycycline. Diabetes promotes periodontal infection and causes periodontitis. The proinflammatory cytokines produced in response to periodontal infection increase the insulin resistance and aggravate Diabetes. Thus diabetes and periodontitis share a bidirectional relationship. The severity of periodontitis is related to the glycaemic control of the patient and not to the duration of diabetes. Control of blood glucose level and maintenance of oral heath are really important in diabetes mellitus. This article reviews the relation between diabetes mellitus and periodontal health.

Nateglinide is an insulin secretogogues, meglitinide anti-diabetic drug used for the treatment of type II Diabetes mellitus. Film coated means 2% coating immediate release tablets. Superdisintegrants used for the formulation of immediate release tablets to decrease the disintegration time of tablets and disaggregate the granules into fines. Current investigation aims to access the impact of gradient concentration of sodium starch glycolate, Crosscarmellose sodium on the disintegration time also drug release rate of tablets. The drug-excipients interaction study was carried out by Fourier Transform Infra-red and Different Scanning Calorimeter. The six formulations were formulated by using 2, 4, 6 % concentration of Superdisintegrants. The hardness of each formulation was in between 100 to 140 N. The disintegration time of formulation containing 6% (F-6), 4% (F-5) and 2 % (F-4) concentration of Crosscarmellose sodium was about 7.0, 6.0 and 3.0 min respectively. The formulation having sodium starch glycolate concentration of 2% (F-1), 4% (F-2), 6% (F-3) about 8.0, 6.0 and 4.0 min respectively. As the concentration of Superdisintegrants get on increase the disintegration time was decrease. The formulation containing sodium starch glycolate had more disintegration time than Crosscarmellose sodium containing tablets.

  Angina bullosa haemorrhagica is a rare blood filled vesiculobullous lesion of the oropharynx with the most common site being reported is the soft palate. Many etiological factors have been reported including trauma, hypertension, hyperglycemia and even iatrogenic causes. Management is based on the dimension of the lesion. Usually smaller lesions are self limiting, but larger lesions require surgical intervention. We report a case of rapidly expanding blood-filled bulla of the soft palate of size 2x4.5 mm with successful management by steroids. It was associated with tightness as prodromal symptom in the area followed by the bullae. The etiology, clinical features, differential diagnosis and management of the lesion is discussed.