The Influence of  Type 2 Diabetes Mellitus on Periodontal Disease

Objective:  Study the association between metabolic status and the extent of periodontal desease (PD) among patients with Type 2 DM (T2DM).

Method: Single center, randomized trial with 90 T2DM patients. Biometric parameters were measured and blood analyses were carried out for HbA1c, HDL, LDL, Triglycerides and glucose. Periodontal clinical parameters were measured by a computerized periodontal probe. PD was classified according to clinical attachment loss (CAL): initial (CAL 1-2mm), moderate (3-4mm) and severe (³5mm). Variables were analyzed by Chi-Square Tests and Multivariable Regression with a significance level of 5%.

Result: A total of 90 individuals were observed: 70 male (77,8%); 20 Female, mean age of 64,3 years (± 9,95), BMI of 29,1kg/m² (±4,42), waist measure of 103,4cm, HbA1c of 6,69% (±0,95), T2DM was diagnosed for 11,3 years (±8,66), and 84% had Dyslipidemia. Patients had in average 21,4 teeth (±7,1), 98,1% had bleeding on probing, 11,1% suppuration and 100% had dental plaque. CAL ranged from 0 to 11 mm. PD was present in 98% of patients: 55% had initial PD, 30% moderate and 15% severe. There is an association between metabolic control (HbA1c) and the severity of PD (p<0,001) but not with the duration of T2DM (p=0,415). From multivariable analysis it was found that regardless metabolic control, diabetic patients had a higher risk of develop PD if they were obese (p<0,001), had higher waist measure (p<0,001) and Dyslipidemia (p=0,025). 

Conclusion:  Patients with T2DM had a high prevalence of PD and its severity is related with current glycemic control. Obesity, high waist measure and Dyslipidemia are a risk factor for PD even with a good glycemic control.