Tratamento integrado de uma adolescente com Diabetes Mellitus Tipo 1: abordagem médica, odontológica e nutricional

Abstract

Type 1 Diabetes Mellitus (DM1) is a disease caused by the destruction of pancreatic beta cells responsible for insulin production that needs to be replaced by exogenous application. Periodontitis is a chronic multifactorial inflammatory disease, associated with dysbiotic biofilm and characterized by progressive destruction of the periodontium of attachment. The influence of one pathology over the other is consolidated, since uncontrolled glycemic indexes caused by diabetes result in the worsening of periodontal disease (PD), at the same time that periodontitis is associated with insulin resistance, changes in glycemia and complications of disease. The present study aims to report the effects of the multidisciplinary treatment of an adolescent with DM1 and periodontitis. Case planning involved quarterly consultations with the pediatric endocrinologist, nutritional monitoring, individualized guidance on physical exercise and PD treatment. Among the results achieved after 6 months of periodontal therapy, the decrease in inflammatory parameters such as bleeding on probing (SS), probing depth (PS) and clinical attachment level (NIC) stands out, despite the SS remaining at 40% of the sites. There was a 0.6% reduction in glycated hemoglobin A1c (HbA1c) 10 months after the start of the multidisciplinary team's involvement in the patient's treatment, and less frequent hypoglycemic crises during the night. The conclusion was that the multidisciplinary involvement in the context of the patient reported here reflected, even if minimally, on her health and quality of life as a whole.