Self-Reported Periodontitis and Complications in Type 1 Diabetes Patients: A Brazilian Nationwide Survey

Abstract

This study aimed to evaluate the possible association between periodontitis and systemic complications in a Brazilian type 1 diabetes population. A multicentre, sectional study was carried out in 28 public clinics located in 20 Brazilian cities. Data from 3,591 patients were obtained (56.0% females, 57.2% Caucasians), with an average age of 21.2 ± 11.7 years and whose mean duration of type 1 diabetes was 9.6 ± 8.1 years. Periodontitis was evaluated through self-report. Odds ratios (OR) and 95% confidence intervals were calculated to evaluate the association between periodontitis and systemic diabetes complications (chronic micro and macrovascular complications and hospitalizations by hyperglycemia and diabetic ketoacidosis). The prevalence of periodontitis was 4.7% (n=170). Periodontitis patients had mean age of 27.4 ± 12.9. This group was older (p<0.001), exhibited longer diabetes duration (p<0.0001) and had elevated total cholesterol (p<0.05), triglycerides (p<0.001) and lower HDL (p<0.05) values than patients without periodontitis. Systolic and diastolic blood pressures were significantly increased in periodontitis patients (p<0.01). Periodontitis patients had increased odds of microvascular complications (2.43 [1.74-3.40]) and of hospitalizations related to hyperglycemia (2.76 [1.72-4.42]) and ketoacidosis (2.72 [1.53-4.80]). In conclusion, periodontitis was associated to systemic complications in Brazilian type 1 diabetes patients.

Clinical implications of age and sex in the prevalence of periodontitis in Korean adults with diabetes

“…In diabetic patients, the elimination of periodontal infections and a reduction in periodontal inflammation produces a noticeable short-term reduction in glycated hemoglobin ( 32 ). Individuals with periodontitis had an increased rate of microvascular complications ketoacidosis and of hospitalizations associated with hyperglycemia with odds ratio and 95% confidence intervals of [2.43 (1.74–3.40)], [2.72 (1.53–4.80)] and [2.76 (1.72–4.42)], respectively ( 33 ). Treatment of periodontitis reduces the risk of cardiovascular disease in diabetic patients ( 34 ).…”

Periodontal disease and its impact on general health in Latin America. Section V: Treatment of periodontitis

“…8 A multi-center study in Brazil indicated that diabetic patients with periodontitis had increased odds of microvascular complications and of hospitalizations related to hyperglycemia and ketoacidosis. 26…”

Periodontal disease in adults with diabetes, prevalence and risk factors. Results of an observational study

“…4,5 Several studies have established the relationship between periodontitis and diabetes, and it seems to be bidirectional. 6 Diabetes is an established risk factor for periodontitis, and periodontitis also influences metabolic control and the development of diabetic complications. 7 It has even been pointed out as an early sign of diabetes mellitus.…”