Palliative complimentary
care in diabetes mellitus (3): Acupuncture, dental care
Health & Fitness By Kemi Ilori
Tuesday, April 17, 2007
The use of complimentary methods for palliative care can
offer relief in people suffering from pain in diabetes mellitus. One such method
is Acupuncture. Diabetes sometimes suffer from pain, especially in the legs. Acupuncture
has been used to help these symptoms without recourse to medication. Acupuncture
is a Chinese therapy that has been used for centuries.
It is based on
the theory that there is energy, called chi or qi, flowing through your body.
Chi is thought to flow along energy pathways called meridians. People often use
acupuncture to relieve pain. Western medical researchers who have studied acupuncture
believe that it may reduce pain through body chemicals that have calming effects
(body chemicals are opioid peptides like endorphins).
Traditional Chinese
acupuncture usually is done by putting very thin needles into the skin at certain
points on the body to produce energy flow along the body's meridians. Other types
of acupuncture may use heat, pressure, or mild electrical current to stimulate
energy flow along these meridians. People use acupuncture to relieve pain and
treat certain health conditions. You can use it by itself or as part of a treatment
program. Last week, I wrote about osteocare. Acupuncture is of immense benefit
in alleviating pain from osteopathic conditions. Conditions which can benefit
from the use of acupuncture in diabetes include;
1) Osteoarthritis, or
the breakdown of the tissue (cartilage) that protects and cushions joints. A recent
study found that acupuncture can reduce knee pain and increase movement of the
knee in people with osteoarthritis.
2) Low back pain.
3) Carpal tunnel
syndrome, or pressure on a nerve in the wrist that results in tingling, numbness,
weakness, or pain of the fingers and hand. Always tell your doctor if you are
using an alternative therapy or if you are thinking about combining an alternative
therapy with your conventional medical treatment. It may not be safe to forgo
your conventional medical treatment and rely only on an alternative therapy.
Oral
and Dental care: It is very important that people with diabetes maintain a strict
oral hygiene. Six monthly visits to the dentist are also advisable. The oral complications
of uncontrolled diabetes mellitus are devastating.
These may include,
but are not necessarily limited to, gingivitis and periodontal disease; xerostomia
(dry mouth) and salivary gland dysfunction; increased susceptibility to bacterial,
viral and fungal (that is, oral thrush or candidiasis) infections; caries; periapical
abscesses; loss of teeth; impaired ability to wear dental prostheses (related
in part to salivary dysfunction); taste impairment; lichen planus; and burning
mouth sensation. The patient with poorly controlled diabetes is at greater risk
of developing periodontal disease. It starts with gingivitis and then, with poor
blood glucose level control, progresses to advanced periodontal disease.
A
study showed that the loss of teeth was 15 times higher in Pima Indians with diabetes
than in Pima Indians without diabetes. The oral complications in patients with
uncontrolled diabetes are most likely related to the increased susceptibility
to infection, micro-vascular changes and, possibly, increased glucose concentrations
in the saliva (salivary hyperglycemia) and gingival crevicular fluid. Salivary
hyperglycemia may be an important contributory factor to periodontal disease.
Increased salivary glucose results in additional bacteria because the bacteria
are able to grow and multiply by feeding on the glucose in the saliva.
This in turn causes plaque formation. Oral sores are also a possible complication
of diabetes. Difficulty in lubricating, chewing, tasting and swallowing are among
the most devastating complications from insufficient saliva and may contribute
to poor food intake. Palliative dental care in diabetes mellitus includes topical
treatments such as fluoride-containing mouthwashes and salivary substitutes to
help prevent caries and minimize discomfort.
As an integral member of
the health care team, the dentist can counsel patients with diabetes to stop smoking—a
risk factor that may exacerbate some of the vascular and dental complications
associated with diabetes. Like I said earlier, good dental hygiene is important
in diabetes. |
