The treatment of diabetes has always centered on the control of blood sugar through medication and appropriate nutritional intake. Preventing oral infection, as an adjunct in controlling blood sugar, has been given little attention. Its significance in a population with a high prevalence of tooth decay and gum disease, such as the Philippines, may be underestimated.
The cost of managing diabetes imposes a heavy burden on families with children affected by the disease. Type I diabetes, or diabetes that usually affects the young, requires daily doses of insulin. Because the amount of insulin required by the body is not constant, a glucose meter (a home monitoring device used to measure sugar in the blood) is necessary in order to avoid overdosing, which can be fatal. Below is a list of monthly expenses of a healthy child with diabetes:
| COST (PHP) | |
|---|---|
| glucose meter (Note: one time cost only unless it breaks down) |
6,500 |
| lancing device (Note: one time cost only unless it breaks down) |
400 |
| glucose meter strips (Note: 60 pcs/month for those monitoring their sugars twice a day) |
4,800 |
| prickers or lancets (100 pcs.) |
300 |
| insulin (single bottle = 1,000 units) |
580 |
| insulin syringe(30 pcs/month) |
180 |
| alcohol |
40 |
| cotton |
40 |
| doctor's fees (single visit/month) |
200 |
| TOTAL |
11,240 |
| Monthly total minus the glucose meter and lancing device |
6900 |
Note: This does not include hospitalization which may occur during times of hypoglycemia (low blood sugar) or diabetes ketoacidosis (a condition that occurs when the blood sugar is high). A three day stay in the hospital can easily cost PHP 5,000 - 15,000
The lack of importance attached to oral health and the financial burden that accompany diabetes makes it easy for families of children with the disease to neglect oral health totally or assign a low level of priority to oral health needs.
Poor oral health can: lead to early loss of teeth, raise blood sugar levels during times of infection, and deter compliance to prescribed diabetic diet. Project: Oral Health for Juvenile Diabetics (POHJD) aims to encourage children with diabetes to take care of their teeth by:
Cooperating agencies involved in this project are:
Funding for this project was initially provided by the JAASH Ressei Committee in Japan through the help of the Religious of the Sacred Heart. A total of 28 juvenile diabetics are currently undergoing dental treatment at the Pediatric Dentistry Center. Most dental procedures are made available to these patients except for fabrication of dentures and orthodontics; although, exceptions are made in some cases. Preventive procedures such as application of topical fluoride and pit and fissure sealants are given priority.