Association of Glycated Hemoglobin Level with Self-Reported Chewing Problems in Elderly Community-Dwelling Individuals in Japan

Abstract

Purpose Chewing problems are associated with increased mortality, geriatric syndromes and poor activities of daily living. Starting in 2018, in Japan, a self-reported questionnaire investigating chewing status was implemented in the annual health checkup program. Considering the bidirectional association between hyperglycemia and poor oral health, it is hypothesized that people with self-reported chewing problems will have relatively poor glycemic profiles. We investigated the metabolic characteristics of elderly community dwellers with self-reported chewing problems, as well as the association between the problems and HbA1c levels. Patients and Methods This was a retrospective, cross-sectional study. We reviewed the data of 1018 adults ≥ 65 years of age who had undergone an annual health checkup at Nihon University Hospital during the period from January 2019 through December 2019. The presence of chewing problems was investigated using a self-reported questionnaire constructed based on guidance provided by the Japanese government. Results In the 1018 participants, the overall prevalence of chewing problems was 10.4%. Participants with chewing problems showed significantly higher levels and worse categories of HbA1c than those without such problems (HbA1c < 6.0%, 42.5% vs 54.8%; HbA1c 6.0–6.9%, 41.5% vs 37.0%; HbA1c ≥ 7.0%, 16.0% vs 8.2%, p = 0.008). Participants with HbA1c ≥ 7.0% have a significantly increased risk of chewing problems as compared to those with HbA1c < 6.0% (odds ratio 2.76, p = 0.002), even after adjusting for the effects of age, sex, body mass index, eating behaviors, and history of diabetes mellitus. Conclusion HbA1c ≥ 7.0% is associated with self-reported chewing problems in elderly Japanese community-dwellers. We thus recommend a proactive assessment of oral conditions for this population.

Teeth Rehabilitation and Nutritional Influence on Diabetic Patients: A Review

“…The study was limited, nevertheless, because information pertinent to the usage of dentures and the history of dental care was not available because these factors were not part of the system for yearly health examinations. This study was done in an urbanized area, and objective evaluations of oral health were not performed in this study [ 49 ]. An interesting cross-sectional study performed on a Chinese population investigated the relation between the number of functional occlusal areas( classified by the Eichner index) and the prevalence of DM2.…”

“…However, few studies have demonstrated a direct relationship between mastication and glucose metabolism. Physicians should check for oral conditions and chewing problems in DM patients with HbA1c ≥7.0% [ 49 ].…”