Prevalence of diabetes mellitus in people clinically diagnosed with periodontitis: A systematic review and meta‐analysis of epidemiologic studies

Abstract

Objectives Diabetes mellitus and periodontitis are complex chronic diseases with an established bidirectional relationship. This systematic review evaluated in subjects with professionally diagnosed periodontitis the prevalence and odds of having diabetes. Methods The MEDLINE‐PubMed, CENTRAL and EMBASE databases were searched. Prevalence of diabetes mellitus among subjects with periodontitis was extracted or if possible calculated. Results From the 803 titles and abstracts that came out of the search, 27 papers met the initial criteria. Prevalence of diabetes was 13.1% among subjects with periodontitis and 9.6% among subjects without periodontitis. Based on subanalysis, for subjects with periodontitis, the prevalence of diabetes was 6.2% when diabetes was self‐reported, compared to 17.3% when diabetes was clinically assessed. The highest prevalence of diabetes among subjects with periodontitis was observed in studies originating from Asian countries (17.2%, n = 18,002) and the lowest in studies describing populations from Europe (4.3%, n = 7,858). The overall odds ratio for patients with diabetes to be among subjects with periodontitis as compared to those without periodontitis was 2.27 (95% CI [1.90;2.72]). A substantial variability in the definitions of periodontitis, combination of self‐reported and clinically assessed diabetes, lack of confounding for diabetes control in included studies introduces estimation bias. Conclusions The overall prevalence and odds of having diabetes are higher within periodontitis populations compared to people without periodontitis. Self‐reported diabetes underestimates the prevalence when compared to this condition assessed clinically. Geographical differences were observed: the highest diabetes prevalence among subjects with periodontitis was observed in studies conducted in Asia and the lowest in studies originating from Europe.

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

“…These conclusions were confirmed in two 2018 review updates [71,72]. Another 2018 systematic review concluded that people with professionally diagnosed periodontitis and clinically assessed diabetes had almost three times greater prevalence (17.3% versus 6.2%) and more than twice the risk (OR = 2.27 (95% CI: 1.90-2.72) of having diabetes than their periodontitis-free peers [73].…”

Impact of natural curcumin on the progression of experimental periodontitis in diabetic rats

“…Diabetes mellitus and periodontitis are complex chronic diseases with an established higher risk for the development periodontitis and future tooth loss in the presence of DM . CURC is a natural compound with promising effects in modulating the osteo‐immune‐inflammatory and antioxidant host response both in periodontally diseased sites and in diabetes and related complications .…”

“…Diabetes mellitus and periodontitis are complex chronic diseases with an established higher risk for the development periodontitis and future tooth loss in the presence of DM. [5][6][7] CURC is a natural compound with promising effects in modulating the osteo-immuneinflammatory and antioxidant host response both in periodontally diseased sites [14][15][16][17]21,22 and in diabetes and related complications. 19,20 For the first time, this investigation assessed the natural curcumin's Although promising effects of natural CURC on periodontal tissues have already been revealed in earlier experimental 14,16,17,27 and also clinical studies, 28,29 only few information is available concerning the influence of a chemically modified CURC on periodontitis in the presence of a recognized at-risk condition as diabetes mellitus 21,22 as employed in the current study) has already proved to be promising as a host modulatory agent in periodontal disease pathogenesis and to reduce the alveolar bone loss related to periodontitis.…”

“…In this context, studies have indicated that the diabetic/hyperglycemic state increases the risk for the development and progression of periodontitis and it is associated with future tooth loss, especially in poorly controlled glycemic status. [5][6][7] In line, earlier investigations revealed that one-third of individuals with diabetes mellitus (DM) presents severe forms of periodontal disease, and adults aged 45 years or older, with poorly controlled glycemic status, are three times more likely to have severe periodontitis than those without diabetes. 8,9 The greater susceptibility of diabetic individuals to periodontal breakdown could be attributed to the modulation of several cyto/ chemokines in favor of a pro-inflammatory host response profile.…”

Periodontal Disease and Risk of Bladder Cancer: A Meta-Analysis of 298476 Participants

“…In China, from 1990 to 2013, the periodontal disease (PD) standardized DALYs rate had increased slightly from 24.7 to 25.7, based on the data from 2013 GBD study (Zhang et al, 2017 ). Moreover, it is indicated in accumulating evidence that PD associated with the increased risk of various systemic diseases, such as cardiovascular disease (Zeng et al, 2017 ), asthma (Moraschini et al, 2018 ), overweight/obesity (Martens et al, 2017 ), inflammatory bowel disease (Papageorgiou et al, 2017 ), systemic lupus erythematosus (Rutter-Locher et al, 2017 ), diabetes mellitus (Ziukaite et al, 2018 ), carotid atherosclerosis (Zeng et al, 2016a ), and erectile dysfunction (Cheraghi and Doosti-Irani, 2017 ). Furthermore, some researches also suggested that PD may be involved in the pathogenesis of malignant tumors (Sadighi Shamami and Amini, 2011 ; Michaud et al, 2017 ).…”