Severe gum disease, which is known as
periodontitis, is often an early indicator of type 2 diabetes.
According to the latest data, diabetes
affects approximately 422 million people worldwide, and this number
is expected to increase.
In the United States, 29 million people
live with the disease. Of these, over 8 million people have it but
have not been diagnosed, according to the Centers for Disease Control
and Prevention (CDC).
The CDC also estimates that 37 percent
of American adults over the age of 20 have prediabetes.
New research - published in the journal
BMJ Open Diabetes Research & Care - suggests severe gum disease,
or periodontitis, might be an early sign of diabetes.
The authors also suggest a simple
finger stick diabetes screening procedure could be carried out in the
dental office to avoid the adverse effects of leaving diabetes
untreated.
Researchers from the University of
Amsterdam in The Netherlands assessed a total of 313 participants
from a dental clinic at the university.
Of these, 126 patients had
mild-to-moderate gum disease, 78 patients had severe periodontitis,
and 198 individuals did not have signs of gum disease.
Participants with periodontitis had a
higher body mass index (BMI) than the rest, with an average BMI of
27. However, other diabetes risk factors - such as high blood
pressure or high cholesterol - were similar across all three groups.
The researchers analyzed higher
glycated hemoglobin (HbA1c) values in dry blood spots, and evaluated
the differences in mean HbA1c values, as well as the prevalence of
diabetes and prediabetes between the two groups.
HbA1c values measure the average level
of blood sugar in the last 2-3 months. The dry blood spots were
obtained by sampling participants' blood using a finger pin-prick
test.
Prediabetes is commonly considered to
range between an HbA1C value of 39-47 millimoles per mol (mmol/mol).
The analysis revealed that those with
the most severe form of periodontitis also had the highest HbA1c
values.
The average HbA1c values for the severe
gum disease group were 45 mmol/mol, compared with 43 mmol/mol in
those with mild-to-moderate gum disease and 39 mmol/mol among those
without gum disease.
Additionally, the researchers found a
high percentage of people with suspected diabetes and prediabetes
among participants with mild-to-moderate as well as severe gum
disease.
In the severe gum disease group, 23
percent of study participants were suspected of diabetes, whereas 14
percent of the mild-to-moderate gum disease participants had
suspected diabetes. In the severe gum disease group, 47 percent had
prediabetes, and 46 percent of those in the mild-to-moderate group
had prediabetes.
By comparison, 37 percent of those with
no gum disease had prediabetes, and 10 percent had suspected
diabetes.
Additionally, the researchers found
previously undiagnosed cases of diabetes across the three groups: 8.5
percent of those with no gum disease and a little under 10 percent of
those with mild-to-moderate gum disease had not been previously
diagnosed with the disease until the study.
As much as 18 percent of those with
severe gum disease had not been diagnosed with diabetes.
The study is observational, so it
cannot explain a causal link between gum disease and diabetes.
However, the authors suggest that screening patients with severe
periodontitis for diabetes as part of dental medical practices might
be an effective way of avoiding complications of the disease.
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