Association of periodontal disease with glycemic control in patients with type 2 diabetes in Indian population

Abstract

This study aims to investigate the link between glycated hemoglobin and diabetic complications with chronic periodontitis. A total of 207 patients with type 2 diabetes and chronic periodontitis (CP) were divided according to tertiles of mean PISA (periodontal inflamed surface area) scores as low, middle and high PISA groups. Simultaneously a group of 67 periodontally healthy individuals (PH) was recruited. Periodontal examinations, including full-mouth assessment of probing depths (PPD), bleeding on probing, clinical attachment level and plaque scores were determined. Blood analyses were carried out for glycated hemoglobin (HbA), fasting plasma glucose (FPG), 2 h post parandial glucose (PPG). Individuals in PH group had significantly better glycemic control than CP group. Upon one-way analysis of variance, subjects with increased PISA had significantly higher HbA levels, retinopathy and nephropathy (P < 0.05). After controlling for age, gender, body mass index (BMI), socioeconomic status (SES), family history of diabetes and periodontitis, duration of diabetes, the mean PISA in mm, PPD 4-6 mm (%) and PPD ≥ 7 mm (%) emerged as significant predictors for elevated HbA in regression model (P < 0.05). Logistic regression analysis revealed that PISA was associated with higher risk of having retinopathy and neuropathy (odds ratio). In our study, the association between glycemic control and diabetic complications with periodontitis was observed.

IDF Diabetes Atlas: Diabetes and oral health – A two-way relationship of clinical importance

“…Diabetic neuropathy can lead to burning mouth syndrome (glossodynia) [49], taste impairment (dysgeusia), and hyposalivation that causes mouth (a risk factor for both periodontal diseases and caries) -and possibly a feeling of mouth dryness (xerostomia). Diabetic neuropathy is also associated with periodontitis in type 2 diabetes, in a dose-response manner [63].…”

“…The severity of diabetic retinopathy and the severity of periodontitis are associated [63,64], as are retinal and gingival hemorrhaging [65], in a dose-response manner with levels of HbA1c.…”

“…Periodontitis is also associated with diabetic nephropathy [20,63]. A study among 207 patients with type 2 diabetes in India reported periodontitis to be associated with glycemic control and diabetic nephropathy [63].…”

Glycemic control and adipokines after periodontal therapy in patients with Type 2 diabetes and chronic periodontitis

“…10,11,12 Conversely, CP may be a risk factor for worsened glycemic control in diabetic individuals and may increase the risk of related complications. 13,14 Currently, the mechanism by which T2DM influences CP is relatively clear, but the direct effect of CP on T2DM is not yet well understood. 9 In recent years, the roles of adipokines in inflammatory responses and insulin resistance (IR) have attracted much attention from researchers.…”

The relationship between periodontitis and diabetic retinopathy: A cross-sectional longitudinal study

“…5 Previous researchers observed the association between periodontitis and poor glycaemic control. 6 The American Diabetes Association recommended a glycated haemoglobin target of <7 to prevent microvascular complications including diabetic retinopathy. 7 Periodontitis is a chronic inflammation of periodontal tissue and may result in tooth loss due to destruction of surrounding bone, the disease is the six complication of diabetes after microvascular and macrovascular complications and delayed wound healing.…”