To the impacts on your health from Type 2 diabetes such as vision problems, cardiovascular issues and nerve degeneration, you can add another, researchers say: tooth loss.
Vision problems or amputations made necessary because of nerve damage are well-known risks facing diabetics, but new research indicates they are also twice as likely to lose teeth on average than nondiabetics.
The risk is even greater for African-Americans, the study authors report.
"We have more evidence that [poor] oral health is related to diabetes," says Bei Wu of Duke University in Durham, N.C.
Gum disease, which affects around half of adults in the U.S., is a common complication in Type 2 diabetes and is more prevalent among those with the condition, she says.
"The ultimate consequence of gum disease is tooth loss," she explains.
Researchers say they examined tooth loss trends in data on more then 37,000 people gathered by the National Health and Nutrition Examination Survey between 1971 and 2012.
While tooth loss has declined overall in the U.S. over those decades, people suffering from diabetes are still vulnerable, the researchers found.
The findings "highlight the need to improve dental self-care and knowledge of diabetes risks among people with diabetes, especially among African-Americans who experience more tooth loss," the study authors report in the journal Preventing Chronic Disease.
The racial disparity in the tooth loss data could be due to the difficulty that blacks traditionally face in obtaining access to good dental care, Wu suggested.
The American Diabetes Association has long recommended that doctors refer diabetic patients to a dentist, Wu says, but "in reality, very few doctors are doing that."
Risk of vision loss normally sends diabetics to eye specialists, and foot exams are often done since nerve damage and poor circulation arising from diabetes can result in amputations.
Seeing a dentist should be considered just as important, Wu says.
"Foot care and eye care are on the top of their agenda, but dental care is not," she says. "Diabetics need to have regular dental care."
Dr. Edmond Hewlett, a spokesman at the American Dental Association, echoed that recommendation.
People with diabetes should brush twice daily, floss at least once a day, and see a dentist at least twice a year, he says.
The study highlights "the connection between oral health and overall health," he says.