Periodontal Status and Glycaemic Control among Type 2 Diabetic Patients- a Comparable Study between 2 Teaching Hospitals in 2 Geographical Zones in Nigeria
Archives of Current Research International,
Background: There is clinical evidence that periodontitis and diabetes mellitus (DM) are interconnected. Thus, periodontitis can promote systemic chronic inflammation that can exacerbate type 2 diabetes mellitus.
Methodology: Data was collected with self-administered questionnaire. Glycaemic control and periodontal status were evaluated by glycated Hb values and CPI respectively. Analysis was done using the Statistical Package for Social Sciences version 20.0 (IBM SPSS Statistics Armonk New York). Association of glycaemic index with periodontal status was explored by the χ2 test and statistical significance was set at P < 0.05.
Results: One hundred and eighty-five participants with type 2 diabetes were recruited with a female predominance in both centers. Majority of participants were above the fifth decade. The mean duration of diabetes was 8.97±7.14. 73.3% of participants in UPTH and 84.7% in LASUTH were out of (p=0.001). One-fourth of participants in LASUTH and 14.2% of participants from UPTH had poor oral hygiene. Twice participants in LASUTH had good glycaemic control compared to those in UPTH (p=0.001). The periodontal status of majority of the participants in the two centers was between CPI score 2 and 4 (p=0.02). The association between good glycaemic control and gender and between good glycaemic control and age were statistically significant (p=0.014; p=0.001).
Conclusion: The periodontal status of participants did not worsen with poor glycaemic control. However, education was significantly associated with extent of control. Periodontal care should be incorporated into the management of the diabetics for improved quality of life.
- glycaemic control
- periodontal status
How to Cite
Sorsa T, Ingman T, Suomalainen K, Haapasalo M, Konttinen YT, Lindy O, et al. Identification of proteases from periodontopathogenic bacteria as activators of latent human neutrophils and fibroblast-type interstitial collagenases. Infect Immun. 1992;60:4491–4495.
Lee W, Aitken S, Sodek J, McCulloch CA. Evidence of a direct relationship between neutrophil collagenase activity and periodontal tissue destruction in vivo: role of active enzyme in human periodontitis. J Periodontal Res. 1995;30:23–33.
Geerts SO, Legrand V, Charpentier J, Albert A, Rompen EH. Further evidence of the association between periodontal conditions and coronary artery disease. J Periodontol. 2004;75:1274–1280.
Kornman KS, Page RC, Tonetti MS. The host response to the microbial challenge in periodontitis: Assembling the players. Periodontol 2000. 1997;14:33–53.
Friedewald VE, Kornman KS, Beck JD, Genco R, Goldfine A, Libby P, et al. The American Journal of Cardiology and Journal of Periodontology editor's consensus: Periodontitis and atherosclerotic cardiovascular disease. J Periodontol. 2009;80:1021–1032.
Amar S, Han X. The impact of periodontal infection on systemic diseases. Med Sci Monit. 2003;9:RA291–RA299.
Kapila YL. Oral health's inextricable connection to systemic health: Special populations bring to bear multimodal relationships and factors connecting periodontal disease to systemic diseases and conditions. Periodontol 2000. 2021; 87(1):11-16.
Abusleme L, Morandini AC, Hashizume-Takizawa T, Sahingur SE. Editorial: Oral Microbiome and Inflammation Connection to Systemic Health. Front Cell Infect Microbiol. 2021;11:780182.
Nazir MA, Izhar F, Akhtar K, Almas K. Dentists' awareness about the link between oral and systemic health. J Family Community Med. 2019;26(3):206-212.
Borgnakke WS, Ylöstalo PV, Taylor GW, Genco RJ. Effect of periodontal disease on diabetes: Systematic review of epidemiological observational evidence J Periodontol. 2013;84(4):S135–S152.
Caton JG, Armitage G, Berglundh T, Chapple ILC, Jepsen S, Kornman KS, et al. A new classification scheme for periodontal and peri-implant diseases and conditions—Introduction and key changes from the 1999 classification J Periodontol. 2018;89(1):S1–S8.
Schmidt AM, Weidman E, Lalla E, Yan SD, Hori O, Cao R, et al. Advanced glycation end products (AGEs) induce oxidant stress in the gingiva: a potential mechanism underlying accelerated periodontal disease associated with diabetes. J Periodontal Res. 1996;31:508–15.
Lalla E, Lamster IB, Drury S, Fu C, Schmidt AM. Hyperglycemia, glycoxidation and receptor for advanced glycation end products: potential mechanisms underlying diabetic complications, including diabetes-associated periodontitis. Periodontol 2000. 2000;23:50–62.
Lalla E, Lamster IB, Schmidt AM. Enhanced interaction of advanced glycation end products with their cellular receptor RAGE. Implications for the pathogenesis of accelerated periodontal disease. Ann Periodontol. 1998;3:13–19.
Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: Framework and proposal of a new classification and case definition J Periodontol 2018;89(1):S159–S172.
Genco RJ, Graziani F, Hasturk H. Effects of periodontal disease on glycemic control, complications, and incidence of diabetes mellitus. Periodontol 2000. 2020;83(1):59–65.
Winning L, Linden GJ Periodontitis and systemic disease: Association or causality? Curr Oral Health Rep. 2017;4: 1–7.
Taylor GW. Bidirectional interrelationships between diabetes and periodontal diseases: an epidemiological perspective Ann Periodontol. 2001;6(1):99–112.
Borgnakke WS. IDF Diabetes Atlas: Diabetes and oral health—A two-way relationship of clinical importance Diabetes Res Clin Pract. 2019;157:107839.
American Diabetes Association. Glycemic Targets: Standards of Medical Care in Diabetes. Diabetes Care. 2018;41(1): S55–S64.
Green JC, Vermillon JR. The simplified oral hygiene index. JADA. 1964;68:7–13.
World Health Organization. Oral Health Surveys, Basic Methods. 4th ed. Geneva, Switzerland: World Health Organization. 1998;1–67.
Sanz M, Ceriello A, Buysschaert M, Chapple I, Demmer RT, Graciani F, et al. Scientific evidence on the links between periodontal diseases and diabetes: Consensus report and guidelines of the joint workshop on periodontal diseases and diabetes by the International Diabetes Federation and the European Federation of Periodontology J Clin Periodontol. 2018; 45:138–149.
Genco RJ, Sanz M Clinical and public health implications of periodontal and systemic diseases: An overview. Periodontol 2000. 2020;83:7–13.
Polak D, Saunui T, Nishimura F, Shapira L Diabetes as a risk factor for periodontal disease-plausible mechanisms. Periodontol 2000. 2020;83(1):46–58.
Lakschevitz F, Aboodi G, Tenenbaum H, Glogauer M Diabetes and periodontal diseases: Interplay and links Curr Diabetes Rev. 2011;7:433–439.
Rapone B, Ferrara E, Corsalini M, Qorri E, Converti I, Lorusso F, et al. Inflammatory status and glycemic control level of patients with type 2 diabetes and periodontitis: A randomized clinical trial. Int J Environ Res Public Health. 2021;18(6): 3018.
Grossi SG, Skrepinski FB, DeCaro T, Robertson DC, Ho AW, Dunford RG, et al. Treatment of periodontal disease in diabetics reduces glycated hemoglobin. J Periodontol. 1997;68(8):713‐719.
Telgi RL, Tandon V, Tangade PS, Tirth A, Kumar S, Yadav V. Efficacy of nonsurgical periodontal therapy on glycaemic control in type II diabetic patients: A randomized controlled clinical trial. J Periodontal Implant Sci. 2013;43(4):177-82.
Santos VR, Lima JA, Miranda TS, Gonçalves TE, Figueiredo LC, Faveri M. Full‐mouth disinfection as a therapeutic protocol for type‐2 diabetic subjects with chronic periodontitis: Twelve‐month clinical outcomes. A randomized controlled clinical trial. Journal of Clinical Periodontology. 2013;40(2):155‐162.
Simpson TC, Weldon JC, Worthington HV, Needleman I, Wild SH, Moles DR, et al. Treatment of periodontal disease for glycaemic control in people with diabetes mellitus. Cochrane Database Syst Rev. 2015;2015(11):CD004714.
Florkowski C. HbA1c standardization issues: should New Zealand follow the DCCT or the IFCC position? N Z Med J. 2003;116(1171): U395.
Hanas R, John G. International HBA1c Consensus Committee. 2010 consensus statement on the worldwide standardization of the hemoglobin A1C measurement. Diabetes Care. 2010;33(8): 1903‐1904.
Engebretson SP, Hyman LG, Michalowicz BS, Schoenfeld ER, Gelato MC, Hou W, et al. The effect of nonsurgical periodontal therapy on hemoglobin A1c levels in persons with type 2 diabetes and chronic periodontitis: a randomized clinical trial. JAMA. 2013;310(23):2523-32.
Kebede TG, Pink C, Rathmann W, Kowall B, Völzke H, Petersmann A, et al. Does periodontitis affect diabetes incidence and haemoglobin A1c change? An 11-year follow-up study. Diabetes Metab. 2018; 44(3):243-249.
Chiu SY, Lai H, Yen AM, Fann JC, Chen LS, Chen HH. Temporal sequence of the bidirectional relationship between hyperglycemia and periodontal disease: a community-based study of 5,885 Taiwanese aged 35-44 years (KCIS No. 32). Acta Diabetol. 2015 ;52(1):123-131.
Demmer, RT, Jacobs DR. Jr, Desvarieux M. Periodontal disease and incident type 2 diabetes: results from the First National Health and Nutrition Examination Survey and its epidemiologic follow-up study. Diabetes Care. 2008;31:1373– 1379.
Ide R, Hoshuyama T, Wilson D, Takahashi K, Higashi T. Periodontal disease and incident diabetes: a seven-year study. Journal of Dental Research. 2011;90:41– 46.
Morita T, Yamazaki Y, Mita A, Takada K, Seto M, Nishinoue N, et al. A cohort study on the association between periodontal disease and the development of metabolic syndrome. J Periodontol. 2010;81:512– 519.
Saito T, Shimazaki Y, Kiyohara Y, Kato I, Kubo M, Iida M, et al. The severity of periodontal disease is associated with the development of glucose intolerance in non-diabetics: The Hisayama study. J Dent Res. 2004;83:485– 490.
Xiong X, Elkind-Hirsch KE, Vastardis S, Delarosa RL, Pridjian G, Buekens P. Periodontal disease is associated with gestational diabetes mellitus: A case-control study. J Periodontol. 2009;80: 1742– 1749.
Preshaw PM, Alba AL, Herrera D, Jepsen S, Konstantinidis A, Makrilakis K, et al. Periodontitis and diabetes: A two- way relationship. Diabetologia. 2012;55: 21–31.
Winning L, Patterson CC, Neville CE, Kee F, Linden GJ. Periodontitis and incident type 2 diabetes: A prospective cohort study. J Clin Periodontol. 2017;44:266–274.
Stoicescu M, Calniceanu H, Țig I, Nemeth S, Tent A, Popa A, et al. Significant aspects and correlation between glycemic control and generalized chronic periodontitis in type 2 diabetes mellitus patients. Exp Ther Med. 2021; 22(1):671.
Shinjo T, Ishikado A, Hasturk H, Pober DM, Paniagua SM, Shah H, et al. Characterization of periodontitis in people with type 1 diabetes of 50 years or longer duration. J Periodontol. 2019;90(6):565-575.
Tinsley LJ, Kupelian V, D'Eon SA, Pober D, Sun JK, King GL, et al. Association of Glycemic Control with Reduced Risk for Large-Vessel Disease After More Than 50 Years of Type 1 Diabetes. J Clin Endocrinol Metab. 2017;102(10):3704-3711.
Abstract View: 62 times
PDF Download: 29 times