Calidad de vida y salud oral en pacientes colombianos con diabetes mellitus tipo 2
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dic 27, 2021
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Resumen
Antecedentes: La diabetes mellitus tipo 2 (DM2) puede afectar la calidad de vida de los pacientes por las lesiones orales relacionadas con la enfermedad y que impactarían sus actividades diarias. Objetivo: Estimar el impacto de las condiciones
Universitas Odontologica, 2021, 40, ISSN: 0120-4319 / 2027-3444
y lesiones orales sobre la calidad de vida relacionada con la salud oral (CVRSO) en pacientes con DM2 pertenecientes a la Fundación MEDICUS en Cartagena, Colombia. Métodos: Se realizó estudio analítico en 152 pacientes que diligenciaron un cuestionario para evaluar variables sociodemográficas y el Índice de Evaluación de la Salud Oral General (GOHAI-C) versión colombiana. Dos examinadores calibrados realizaron la evaluación clínica oral. Se realizó regresión de Poisson para asociar las condiciones clínicas orales y socioeconómicas con los dominios y el puntaje total del GOHAI. Resultados: El 74,34 % de los pacientes presentaba más de 5 años con DM2 diagnosticada. El modelo ajustado multivariado mostró que los pacientes con DM2 que presentaban bajo flujo salival (RR = 1,08; p < 0,001) y estomatitis subprotésica (RR = 1,10; p = 0,001) tenían una probabilidad mayor de tener un impacto negativo sobre las puntuaciones totales del GOHAI. Por otra parte, otras lesiones orales como periodontitis (RR= 0,95; p = 0,046), lengua geográfica (RR = 0,94; p = 0,013), sialosis (RR = 0,85; p = <0,000) y tener <19 dientes en boca (RR = 0,94; p = 0,006) tenían un impacto positivo. Conclusiones: La estomatitis subprotésica y el bajo flujo salival mostraron un impacto negativo sobre la CVRSO de los pacientes colombianos con DM2 analizados.
Keywords
dental prostheses, dentistry, diabetes mellitus type 2, oral health, periodontitis, quality of life, stomatitis, salivacalidad de vida, diabetes mellitus tipo 2, estomatitis, odontología, periodontitis, prótesis dental, saliva, salud oraldiabetes mellitus tipo 2, estomatite, odontologia, periodontite, prótese dental, qualidade de vida, saliva, saúde bucal
References
1. Carrillo-Larco RM, Pearson-Stuttard J, Bernabe-Ortiz A, Gregg EW. The Andean Latin-American burden of diabetes attributable to high body mass index: A comparative risk assessment. Diabetes Res Clin Pract. 2020 Feb; 160: 107978. https://doi.org/10.1016/j.diabres.2019.107978
2. Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Estimaciones mundiales de la prevalencia de diabetes para 2013 y proyecciones para 2035. Inv Práctica Clín Diabetes. 2014 fe; 103(2): 137-149. https://doi.org/10.1016/j.diabres.2013.11.002 137-49.
3. Avilés-Santa ML, Monroig-Rivera A, Soto-Soto A, Lindberg NM. Current state of diabetes mellitus prevalence, awareness, treatment, and control in Latin America: challenges and innovative solutions to improve health outcomes across the continent. Curr Diab Rep. 2020 Oct; 20(11):62. https://doi.org/10.1007/s11892-020-01341-9
4. Camacho PA, Gomez-Arbelaez D, Otero J, González-Gómez S, Molina DI, Sanchez G, Arcos E, Narvaez C, García H, Pérez M, Hernandez-Triana E, Duran M, Cure C, Sotomayor A, Rico A, Cotes F, Rangarajan S, Yusuf S, López-Jaramillo P. Self-reported prevalence of chronic non-communicable diseases in relation to socioeconomic and educational factors in Colombia: a community-based study in 11 departments. Glob Heart. 2020 Apr 21; 15(1): 35. https://doi.org/10.5334/gh.792
5. Simpson TC, Weldon JC, Worthington HV, Needleman I, Wild SH, Moles DR, Stevenson B, Furness S, Iheozor-Ejiofor Z. Treatment of periodontal disease for glycaemic control in people with diabetes mellitus. Cochrane Database Syst Rev. 2015 Nov 6; (11): CD004714. https://doi.org/10.1002/14651858
6. Porto I, Díaz S. Repercusiones de la salud bucal sobre calidad de vida por ciclo vital individual. Acta Odontol Col. 2017 Jul; 7(2): 49-64. http://www.revistas.unal.edu.co/index.php/actaodontocoll
7. Khalifa N, Rahman B, Gaintantzopoulou MD, Al-Amad S, Awad MM. Oral health status and oral health-related quality of life among patients with type 2 diabetes mellitus in the United Arab Emirates: a matched case-control study. Health Qual Life Outcomes. 2020 Jun 15; 18(1): 182. https://doi.org/10.1186/s12955-020-01418-9
8. Atchison KA, Dolan TA. Development of the Geriatric Oral Health Assessment Index. J Dent Educ. 1990 Nov; 54(11): 680-687.
9. Cerón-Bastidas XA. Relación de calidad de vida y salud oral en la población adolescente. Rev CES Odontol. Jun 2018; 31(1): 38-46. http://dx.doi.org/10.21615/ cesodon.31.1.4
10. Valladales-Restrepo LF, Machado-Alba JE. Potentially inappropriate anticholinergic drug prescriptions for patients with Sjögren's syndrome. J Transl Autoimmun. 2019 Jun 27; 2: 100007. http://dx.doi.org/10.1016/j.jtauto.2019.100007
11. Botero JE, Rodríguez C, Agudelo-Suarez AA. Periodontal treatment and glycaemic control in patients with diabetes and periodontitis: an umbrella review. Aust Dent J. 2016 Jun; 61(2): 134-48. http://dx.doi.org/10.1111/adj.12413
12. Vázquez Machado A, Mukamutara J. Depresión en pacientes con diabetes mellitus y su relación con el control glucémico. MEDISAN. 2020; 24(5): 847-860.
13. Concha-Sanchez SC. Relación de la salud oral con las enfermedades crónicas en las personas mayores: una revisión. Rev USTASalud Odontol. 2006 May; 5: 49–63 https://doi.org/10.15332/us.v5i1.1822
14. de Miguel-Infante A, Martinez-Huedo MA, Mora-Zamorano E, Hernández-Barrera V, Jiménez-Trujillo I, de Burgos-Lunar C, Cardenas Valladolid J, Jiménez-García R, Lopez-de-Andrés A. Periodontal disease in adults with diabetes, prevalence and risk factors. Results of an observational study. Int J Clin Pract. 2018 Nov 16: e13294. https://doi.org/10.1111/ijcp.13294
15. Walker RJ, Smalls BL, Campbell JA, Strom Williams JL, Egede LE. Impact of social determinants of health on outcomes for type 2 diabetes: a systematic review. Endocrine. 2014 Sep; 47(1): 29-48. https://doi.org/10.1007/s12020-014-0195-0
16. Castaño J, Ortega A, Ortega J, Palacios JM, Contreras A. Diabetes mellitus tipo 1 y condición periodontal. Rev Nal Odontol. 2014; 10(18): 7-14. https://doi.org/10.16925/od.v10i18.716
17. Rodríguez-Medina C, Agudelo-Suárez AA, Botero JE. Weak evidence hinders the understanding of the benefits of periodontal therapy on glycemic control in patients with diabetes and periodontitis. J Evid Based Dent Pract. 2016 Dec; 16(4): 236-238. https://doi.org/10.1016/j.jebdp.2016.11.005
18. Aguirre-Bustamante J, Barón-López FJ, Carmona-González FJ, Pérez-Farinós N, Wärnberg J. Validation of a modified version of the Spanish Geriatric Oral Health Assessment Index (GOHAI-SP) for adults and elder people. BMC Oral Health. 2020 Feb 19; 20(1): 61. https://doi.org/10.1186/s12903-020-1047-3
19. Gutiérrez Quiceno B, Calzada Gutiérrez MT, Fandiño-Losada A. Cultural adaptation and validation of the Geriatric Oral Health Assessment Index - GOHAI - Colombian version. Colomb Med (Cali). 2019 Jun 30; 50(2): 102-114. https://doi.org/10.25100/cm.v50i2.3999
20. Fuentes-García A, Lera L, Sánchez H, Albala C. Oral health-related quality of life of older people from three South American cities. Gerodontol. 2013 Mar; 30(1): 67-75. https://doi.org/10.1111/j.1741-2358.2012.00649.x
21. Organización Mundial de la Salud (OMS). Ficha de datos de salud bucal 2018. Ginebra: OMS; 2018.
22. Petersen PE, Baez RJ, Ogawa H. Global application of oral disease prevention and health promotion as measured 10 years after the 2007 World Health Assembly statement on oral health. Community Dent Oral Epidemiol. 2020 Aug; 48(4): 338-348. https://doi.org/10.1111/cdoe.12538
23. Ferreira RC, Kawachi I, Souza JGS, Campos FL, Chalub LLFH, Antunes JLF. ¿La dentición reducida con y sin prótesis dental está asociada con la calidad de vida relacionada con la salud oral? Un estudio transversal. Resultados de calidad de vida en salud. Health Quality Life Outcomes. 2019; 17(1): 79 https://doi.org/10.1186/s12955-019-1149-2
24. Montero J, Castillo-Oyagüe R, Lynch CD, Albaladejo A, Castaño A. Self-perceived changes in oral health-related quality of life after receiving different types of conventional prosthetic treatments: a cohort follow-up study. J Dent. 2013 Jun; 41(6): 493-503. https://doi.org/10.1016/j.jdent.2013.01.006
25. Yen YY, Lee HE, Wu YM, Lan SJ, Wang WC, Du JK, Huang ST, Hsu KJ. Impact of removable dentures on oral health-related quality of life among elderly adults in Taiwan. BMC Oral Health. 2015 Jan 5; 15: 1. https://doi.org/10.1186/1472-6831-15-1
26. Hahnel S, Schwarz S, Zeman F, Schäfer L, Behr M. Prevalence of xerostomia and hyposalivation and their association with quality of life in elderly patients in dependence on dental status and prosthetic rehabilitation: a pilot study. J Dent. 2014 Jun; 42(6): 664-70. https://doi.org/10.1016/j.jdent.2014.03.003
27. Atchison KA, Der-Martirosian C, Gift HC. Components of self-reported oral health and general health in racial and ethnic groups. J Public Health Dent. 1998 Fall; 58(4): 301-308. https://doi.org/10.1111/j.1752-7325.1998.tb03013.x
28. Lima DLF, Carneiro SDRM, Barbosa FTS, Saintrain MVL, Moizan JAH, Doucet J. Salivary flow and xerostomia in older patients with type 2 diabetes mellitus. PLoS One. 2017 Aug 2; 12(8): e0180891. https://doi.org/10.1371/journal.pone.0180891
29. Cervino G, Terranova A, Briguglio F, De Stefano R, Famà F, D'Amico C, Amoroso G, Marino S, Gorassini F, Mastroieni R, Scoglio C, Catalano F, Lauritano F, Matarese M, Lo Giudice R, Nastro Siniscalchi E, Fiorillo L. Diabetes: Oral health related quality of life and oral alterations. Biomed Res Int. 2019 Mar 18; 2019: 5907195. https://doi.org/10.1155/2019/5907195
30. Brown AF, Ettner SL, Piette J, Weinberger M, Gregg E, Shapiro MF, Karter AJ, Safford M, Waitzfelder B, Prata PA, Beckles GL. Socioeconomic position and health among persons with diabetes mellitus: a conceptual framework and review of the literature. Epidemiol Rev. 2004; 26: 63-77. https://doi.org/10.1093/epirev/mxh002
31. Irani FC, Wassall RR, Preshaw PM. Impact of periodontal status on oral health-related quality of life in patients with and without type 2 diabetes. J Dent. 2015 May; (5): 506-11. https://doi.org/10.1016/j.jdent.2015.03.001
32. Niesten D, van Mourik K, van der Sanden W. The impact of frailty on oral care behavior of older people: a qualitative study. BMC Oral Health. 2013 Nov 1; 13: 61. https://doi.org/10.1186/1472-6831-13-61
33. Schmalz G, Schiffers N, Schwabe S, Vasko R, Müller GA, Haak R, Mausberg RF, Ziebolz D. Dental and periodontal health, and microbiological and salivary conditions in patients with or without diabetes undergoing haemodialysis. Int Dent J. 2017 Jun; 67(3): 186-193. https://doi.org/10.1111/idj.12282
34. Schmalz G, Noack S, Patschan S, Patschan D, Müller GA, Rupprecht A, Schmickler J, Haak R, Ziebolz D. Disease activity, morning stiffness and missing teeth are associated with oral health-related quality of life in individuals with rheumatoid arthritis. Clin Oral Investig. 2020 Oct; 24(10): 3559-3566. https://doi.org/10.1007/s00784-020-03226-3
35. Bijlsma-Rutte A, Rutters F, Elders PJM, Bot SDM, Nijpels G. Socio-economic status and HbA1c in type 2 diabetes: A systematic review and meta-analysis. Diabetes Metab Res Rev. 2018 Sep; 34(6): e3008. https://doi.org/10.1002/dmrr.3008
36. Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, Charlson FJ, Norman RE, Flaxman AD, Johns N, Burstein R, Murray CJ, Vos T. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet. 2013 Nov 9; 382(9904): 1575-1586. https://doi.org/10.1016/S0140-6736(13)61611-6
37. Carvalho AF, Heilig M, Perez A, Probst C, Rehm J. Alcohol use disorders. Lancet. 2019 Aug 31; 394(10200): 781-792. https://doi.org/10.1016/S0140-6736(19)31775-1
2. Guariguata L, Whiting DR, Hambleton I, Beagley J, Linnenkamp U, Shaw JE. Estimaciones mundiales de la prevalencia de diabetes para 2013 y proyecciones para 2035. Inv Práctica Clín Diabetes. 2014 fe; 103(2): 137-149. https://doi.org/10.1016/j.diabres.2013.11.002 137-49.
3. Avilés-Santa ML, Monroig-Rivera A, Soto-Soto A, Lindberg NM. Current state of diabetes mellitus prevalence, awareness, treatment, and control in Latin America: challenges and innovative solutions to improve health outcomes across the continent. Curr Diab Rep. 2020 Oct; 20(11):62. https://doi.org/10.1007/s11892-020-01341-9
4. Camacho PA, Gomez-Arbelaez D, Otero J, González-Gómez S, Molina DI, Sanchez G, Arcos E, Narvaez C, García H, Pérez M, Hernandez-Triana E, Duran M, Cure C, Sotomayor A, Rico A, Cotes F, Rangarajan S, Yusuf S, López-Jaramillo P. Self-reported prevalence of chronic non-communicable diseases in relation to socioeconomic and educational factors in Colombia: a community-based study in 11 departments. Glob Heart. 2020 Apr 21; 15(1): 35. https://doi.org/10.5334/gh.792
5. Simpson TC, Weldon JC, Worthington HV, Needleman I, Wild SH, Moles DR, Stevenson B, Furness S, Iheozor-Ejiofor Z. Treatment of periodontal disease for glycaemic control in people with diabetes mellitus. Cochrane Database Syst Rev. 2015 Nov 6; (11): CD004714. https://doi.org/10.1002/14651858
6. Porto I, Díaz S. Repercusiones de la salud bucal sobre calidad de vida por ciclo vital individual. Acta Odontol Col. 2017 Jul; 7(2): 49-64. http://www.revistas.unal.edu.co/index.php/actaodontocoll
7. Khalifa N, Rahman B, Gaintantzopoulou MD, Al-Amad S, Awad MM. Oral health status and oral health-related quality of life among patients with type 2 diabetes mellitus in the United Arab Emirates: a matched case-control study. Health Qual Life Outcomes. 2020 Jun 15; 18(1): 182. https://doi.org/10.1186/s12955-020-01418-9
8. Atchison KA, Dolan TA. Development of the Geriatric Oral Health Assessment Index. J Dent Educ. 1990 Nov; 54(11): 680-687.
9. Cerón-Bastidas XA. Relación de calidad de vida y salud oral en la población adolescente. Rev CES Odontol. Jun 2018; 31(1): 38-46. http://dx.doi.org/10.21615/ cesodon.31.1.4
10. Valladales-Restrepo LF, Machado-Alba JE. Potentially inappropriate anticholinergic drug prescriptions for patients with Sjögren's syndrome. J Transl Autoimmun. 2019 Jun 27; 2: 100007. http://dx.doi.org/10.1016/j.jtauto.2019.100007
11. Botero JE, Rodríguez C, Agudelo-Suarez AA. Periodontal treatment and glycaemic control in patients with diabetes and periodontitis: an umbrella review. Aust Dent J. 2016 Jun; 61(2): 134-48. http://dx.doi.org/10.1111/adj.12413
12. Vázquez Machado A, Mukamutara J. Depresión en pacientes con diabetes mellitus y su relación con el control glucémico. MEDISAN. 2020; 24(5): 847-860.
13. Concha-Sanchez SC. Relación de la salud oral con las enfermedades crónicas en las personas mayores: una revisión. Rev USTASalud Odontol. 2006 May; 5: 49–63 https://doi.org/10.15332/us.v5i1.1822
14. de Miguel-Infante A, Martinez-Huedo MA, Mora-Zamorano E, Hernández-Barrera V, Jiménez-Trujillo I, de Burgos-Lunar C, Cardenas Valladolid J, Jiménez-García R, Lopez-de-Andrés A. Periodontal disease in adults with diabetes, prevalence and risk factors. Results of an observational study. Int J Clin Pract. 2018 Nov 16: e13294. https://doi.org/10.1111/ijcp.13294
15. Walker RJ, Smalls BL, Campbell JA, Strom Williams JL, Egede LE. Impact of social determinants of health on outcomes for type 2 diabetes: a systematic review. Endocrine. 2014 Sep; 47(1): 29-48. https://doi.org/10.1007/s12020-014-0195-0
16. Castaño J, Ortega A, Ortega J, Palacios JM, Contreras A. Diabetes mellitus tipo 1 y condición periodontal. Rev Nal Odontol. 2014; 10(18): 7-14. https://doi.org/10.16925/od.v10i18.716
17. Rodríguez-Medina C, Agudelo-Suárez AA, Botero JE. Weak evidence hinders the understanding of the benefits of periodontal therapy on glycemic control in patients with diabetes and periodontitis. J Evid Based Dent Pract. 2016 Dec; 16(4): 236-238. https://doi.org/10.1016/j.jebdp.2016.11.005
18. Aguirre-Bustamante J, Barón-López FJ, Carmona-González FJ, Pérez-Farinós N, Wärnberg J. Validation of a modified version of the Spanish Geriatric Oral Health Assessment Index (GOHAI-SP) for adults and elder people. BMC Oral Health. 2020 Feb 19; 20(1): 61. https://doi.org/10.1186/s12903-020-1047-3
19. Gutiérrez Quiceno B, Calzada Gutiérrez MT, Fandiño-Losada A. Cultural adaptation and validation of the Geriatric Oral Health Assessment Index - GOHAI - Colombian version. Colomb Med (Cali). 2019 Jun 30; 50(2): 102-114. https://doi.org/10.25100/cm.v50i2.3999
20. Fuentes-García A, Lera L, Sánchez H, Albala C. Oral health-related quality of life of older people from three South American cities. Gerodontol. 2013 Mar; 30(1): 67-75. https://doi.org/10.1111/j.1741-2358.2012.00649.x
21. Organización Mundial de la Salud (OMS). Ficha de datos de salud bucal 2018. Ginebra: OMS; 2018.
22. Petersen PE, Baez RJ, Ogawa H. Global application of oral disease prevention and health promotion as measured 10 years after the 2007 World Health Assembly statement on oral health. Community Dent Oral Epidemiol. 2020 Aug; 48(4): 338-348. https://doi.org/10.1111/cdoe.12538
23. Ferreira RC, Kawachi I, Souza JGS, Campos FL, Chalub LLFH, Antunes JLF. ¿La dentición reducida con y sin prótesis dental está asociada con la calidad de vida relacionada con la salud oral? Un estudio transversal. Resultados de calidad de vida en salud. Health Quality Life Outcomes. 2019; 17(1): 79 https://doi.org/10.1186/s12955-019-1149-2
24. Montero J, Castillo-Oyagüe R, Lynch CD, Albaladejo A, Castaño A. Self-perceived changes in oral health-related quality of life after receiving different types of conventional prosthetic treatments: a cohort follow-up study. J Dent. 2013 Jun; 41(6): 493-503. https://doi.org/10.1016/j.jdent.2013.01.006
25. Yen YY, Lee HE, Wu YM, Lan SJ, Wang WC, Du JK, Huang ST, Hsu KJ. Impact of removable dentures on oral health-related quality of life among elderly adults in Taiwan. BMC Oral Health. 2015 Jan 5; 15: 1. https://doi.org/10.1186/1472-6831-15-1
26. Hahnel S, Schwarz S, Zeman F, Schäfer L, Behr M. Prevalence of xerostomia and hyposalivation and their association with quality of life in elderly patients in dependence on dental status and prosthetic rehabilitation: a pilot study. J Dent. 2014 Jun; 42(6): 664-70. https://doi.org/10.1016/j.jdent.2014.03.003
27. Atchison KA, Der-Martirosian C, Gift HC. Components of self-reported oral health and general health in racial and ethnic groups. J Public Health Dent. 1998 Fall; 58(4): 301-308. https://doi.org/10.1111/j.1752-7325.1998.tb03013.x
28. Lima DLF, Carneiro SDRM, Barbosa FTS, Saintrain MVL, Moizan JAH, Doucet J. Salivary flow and xerostomia in older patients with type 2 diabetes mellitus. PLoS One. 2017 Aug 2; 12(8): e0180891. https://doi.org/10.1371/journal.pone.0180891
29. Cervino G, Terranova A, Briguglio F, De Stefano R, Famà F, D'Amico C, Amoroso G, Marino S, Gorassini F, Mastroieni R, Scoglio C, Catalano F, Lauritano F, Matarese M, Lo Giudice R, Nastro Siniscalchi E, Fiorillo L. Diabetes: Oral health related quality of life and oral alterations. Biomed Res Int. 2019 Mar 18; 2019: 5907195. https://doi.org/10.1155/2019/5907195
30. Brown AF, Ettner SL, Piette J, Weinberger M, Gregg E, Shapiro MF, Karter AJ, Safford M, Waitzfelder B, Prata PA, Beckles GL. Socioeconomic position and health among persons with diabetes mellitus: a conceptual framework and review of the literature. Epidemiol Rev. 2004; 26: 63-77. https://doi.org/10.1093/epirev/mxh002
31. Irani FC, Wassall RR, Preshaw PM. Impact of periodontal status on oral health-related quality of life in patients with and without type 2 diabetes. J Dent. 2015 May; (5): 506-11. https://doi.org/10.1016/j.jdent.2015.03.001
32. Niesten D, van Mourik K, van der Sanden W. The impact of frailty on oral care behavior of older people: a qualitative study. BMC Oral Health. 2013 Nov 1; 13: 61. https://doi.org/10.1186/1472-6831-13-61
33. Schmalz G, Schiffers N, Schwabe S, Vasko R, Müller GA, Haak R, Mausberg RF, Ziebolz D. Dental and periodontal health, and microbiological and salivary conditions in patients with or without diabetes undergoing haemodialysis. Int Dent J. 2017 Jun; 67(3): 186-193. https://doi.org/10.1111/idj.12282
34. Schmalz G, Noack S, Patschan S, Patschan D, Müller GA, Rupprecht A, Schmickler J, Haak R, Ziebolz D. Disease activity, morning stiffness and missing teeth are associated with oral health-related quality of life in individuals with rheumatoid arthritis. Clin Oral Investig. 2020 Oct; 24(10): 3559-3566. https://doi.org/10.1007/s00784-020-03226-3
35. Bijlsma-Rutte A, Rutters F, Elders PJM, Bot SDM, Nijpels G. Socio-economic status and HbA1c in type 2 diabetes: A systematic review and meta-analysis. Diabetes Metab Res Rev. 2018 Sep; 34(6): e3008. https://doi.org/10.1002/dmrr.3008
36. Whiteford HA, Degenhardt L, Rehm J, Baxter AJ, Ferrari AJ, Erskine HE, Charlson FJ, Norman RE, Flaxman AD, Johns N, Burstein R, Murray CJ, Vos T. Global burden of disease attributable to mental and substance use disorders: findings from the Global Burden of Disease Study 2010. Lancet. 2013 Nov 9; 382(9904): 1575-1586. https://doi.org/10.1016/S0140-6736(13)61611-6
37. Carvalho AF, Heilig M, Perez A, Probst C, Rehm J. Alcohol use disorders. Lancet. 2019 Aug 31; 394(10200): 781-792. https://doi.org/10.1016/S0140-6736(19)31775-1
Cómo citar
Díaz Cárdenas, S., Vergara Hernández, C. I., Brugés Ruiz, J. A., & Espitaleta Mejía, M. del C. (2021). Calidad de vida y salud oral en pacientes colombianos con diabetes mellitus tipo 2. Universitas Odontologica, 40. https://doi.org/10.11144/Javeriana.uo40.qloh
Número
Sección
Salud Pública y Epidemiología Oral
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