Periodontitis as a possible early sign of diabetes mellitus

Abstract

ObjectiveThe early diagnosis of (pre)diabetes mellitus is essential for the prevention of diabetes complications. It has been suggested that gum disease (periodontitis) might be an early complication of diabetes and may be a useful risk indicator for diabetes screening. Therefore, a dental office could be a good location for screening for (pre)diabetes in patients with periodontitis using a validated glycated hemoglobin (HbA1c) dry spot analysis.Research design and methodsA total of 313 individuals from a university dental clinic participated. From 126 patients with mild/moderate periodontitis, 78 patients with severe periodontitis and 109 subjects without periodontitis, HbA1c values were obtained by the analysis of dry blood spots. Differences in mean HbA1c values and the prevalence of (pre)diabetes between the groups were analyzed.ResultsThe mild/moderate and severe periodontitis groups showed significantly higher HbA1c values (6.1%±1.4% (43 mmol/mol±15 mmol/mol) and 6.3%±1.3% (45 mmol/mol±15 mmol/mol), respectively) compared with the control group (5.7%±0.7% (39 mmol/mol±8 mmol/mol), p=0.003). In addition, according to the American Diabetes Association (ADA) guidelines for diagnosis, there was a significant over-representation of subjects with suspected diabetes (23% and 14%) and pre-diabetes (47% and 46%) in the severe periodontitis group and mild/moderate periodontitis groups, respectively, compared with the control group (10% and 37%, p=0.010). Notably, 18.1% of patients with suspected new diabetes were found among subjects with severe periodontitis compared with 9.9% and 8.5% among subjects with mild/moderate periodontitis and controls, respectively (p=0.024).ConclusionsThe dental office, with particular focus on patients with severe periodontitis, proved to be a suitable location for screening for (pre)diabetes; a considerable number of suspected new diabetes cases were identified. The early diagnosis and treatment of (pre)diabetes help to prevent more severe complications and benefit the treatment of periodontitis.

Relationship between serum 25‐hydroxyvitamin D3levels and severity of chronic periodontitis in type 2 diabetic patients: A cross‐sectional study

“…In this study, we found a strong correlation between serum 25(OH)D 3 deficiency and the severity of type 2 diabetic periodontitis. Consistent with previous reports, T2DCP patients had a more severe periodontal status along with higher serum levels of IL‐1β and TNF‐α than CP patients without diabetes. We conjectured that factors such as age, FBG, HbA1c, and the systemic inflammatory status other than calculus metabolism may influence the risk of periodontitis in diabetes in the face of VD 3 deficiency.…”

“…Periodontitis is a major complication of type 2 diabetes mellitus (T2DM) . Patients with type 2 diabetic periodontitis (T2DCP) often suffer from severe periodontal tissue inflammation and destruction . Although T2DM and chronic periodontitis (CP) have relatively higher incidences with age in the general population, and those that are already afflicted with one disease are more inclined to develop the other, the specific metabolic risk factors and pathological mechanisms mediating these associations have yet to be identified.…”

Association between diabetes mellitus/hyperglycaemia and peri‐implant diseases: Systematic review and meta‐analysis

“…Given the suggested dose–response relationship between blood glucose level and implant complications, patients with (pre‐)diabetes should not only be advised regarding the importance of attaining and maintaining good glycaemic control both for general health, but also for the sake of preventing implant failure. Furthermore, due to the high rate of undiagnosed (pre‐)diabetes that leaves the patient unaware of his or her hyperglycaemia, it would also be prudent to be prepared to offer the patient chairside assessment that could be done by collecting blood samples and sending them to a laboratory on a weekly basis for measurement of the HbA1c from a dry blood spot (Teeuw, Kosho, Poland, Gerdes, & Loos, ).…”

Effect of periodontal therapy with systemic antimicrobials on parameters of metabolic syndrome: A randomized clinical trial

“…Although this investigation was not designed as a cross‐sectional or a population survey, it is interesting to note that the prevalence of MetS in our periodontitis population is higher than the prevalence reported previously in a cross‐sectional study in a Dutch population (Bos et al., ) and also higher than the prevalence of MetS reported in various populations in Europe (5%–27%) (Alberti et al., ). Interestingly, a recent investigation into hidden diabetes in periodontitis patients suggested that periodontitis is a possible early indicator of disturbed metabolic control (Teeuw, Kosho, Poland, Gerdes, & Loos, ). The current findings also point to the same direction and suggest that periodontitis patients may present with undiagnosed metabolic disturbances.…”