This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. In this study, Specifically, we will elucidate the exact biochemical mechanisms responsible for the 'aggravating (priming)' of certain cells in diabetes and determine if these alterations are prevented when the patients are brought under glycemic (blood sugar) control and/or treated for gum disease. Approximately 250 diabetic patients will be enrolled during the entire 5 year study. After providing consent, subjects will be interviewed by study personnel to collect detailed information about demographics, years of education, employment history, and physical activity. If a subject meets all the medical and dental inclusion criteria, he/she will undergo a baseline dental examination to categorize the presence and extent gum disease. The examination will also include new dental x-rays, unless recent films (within 6 months) are available. The oral examination will be performed by the study periodontists. The patients will be given a full mouth dental cleaning to compensate their participation at the same visit. They will be referred to the appropriate dental cleaning in any dental treatment is necessary. Neutrophils and LPS will be isolated from the blood sample and used in experiments to determine neutrophil responsiveness and macrophage stimulation. Control subjects without diabetes will be enrolled to take blood sample to be compared to the sample of diabetics. Usually for each of the diabetic blood sample, a control blood sample is needed to compare the results. Therefore, approximately 250 subjects with diabetes and 250 subjects without diabetes will be enrolled in the study.
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