Epidemiologic relationship between periodontitis and type 2 diabetes mellitus

Abstract

Background: To systematically review the epidemiologic relationship between periodontitis and type 2 diabetes mellitus (T2DM). Methods: Four electronic databases were searched up until December 2018. The manual search included the reference lists of the included studies and relevant journals. Observational studies evaluating the relationship between T2DM and periodontitis were included. Meta-analyses were conducted using STATA. Results: A total of 53 observational studies were included. The Adjusted T2DM prevalence was significantly higher in periodontitis patients (OR = 4.04, p = 0.000), and vice versa (OR = 1.58, p = 0.000). T2DM patients had significantly worse periodontal status, as reflected in a 0.61 mm deeper periodontal pocket, a 0.89 mm higher attachment loss and approximately 2 more lost teeth (all p = 0.000), than those without T2DM. The results of the cohort studies found that T2DM could elevate the risk of developing periodontitis by 34% (p = 0.002). The glycemic control of T2DM patients might result in different periodontitis outcomes. Severe periodontitis increased the incidence of T2DM by 53% (p = 0.000), and this result was stable. In contrast, the impact of mild periodontitis on T2DM incidence (RR = 1.28, p = 0.007) was less robust. Conclusions: There is an evident bidirectional relationship between T2DM and periodontitis. Further well-designed cohort studies are needed to confirm this finding. Our results suggest that both dentists and physicians need to be aware of the strong connection between periodontitis and T2DM. Controlling these two diseases might help prevent each other's incidence.

Inflammatory Status and Glycemic Control Level of Patients with Type 2 Diabetes and Periodontitis: A Randomized Clinical Trial

“…Diabetes is a complex metabolic disorder affecting the glucose status of the human body, characterized by impaired action, secretion of insulin or both, resulting in hyperglycemia [ 12 , 13 , 17 , 18 , 19 , 21 , 22 , 34 ]. Chronic hyperglycemia related to diabetes is associated with end organ failure.…”

“…However, also our results show that the CRP value was plausibly elevated in patients with periodontitis and diabetes, but no statistically significant relationship between all the variables was found. While more is becoming known regarding the role of inflammatory pathways linking diabetes and periodontitis, there remain many open questions [ 11 , 12 , 13 , 17 , 18 , 19 , 21 , 22 , 54 ].…”

“…Specifically, the pathway model that aggregates the knowledge about the impact of diabetes on periodontal status have been well-documented and characterized [ 14 ]. Data on the clinical impact of diabetes on periodontal inflammation enhancement come from two sources: the potential direct effect of hyperglycemic status, which may be responsible for the oral microbiome shifting, impaired cellular function and host defense, and upregulation of the circulant proinflammatory mediators known to be released primarily by immune cells [ 21 , 22 , 23 , 24 , 25 , 26 , 27 ]; the accelerated glycation of protein and lipids mediated by Advanced glycation end products (AGES) and fatty acids, which may indirectly contribute to the degenerative process of periodontal tissues and influence negatively osteogenesis [ 28 , 29 , 30 , 31 , 32 , 33 ]. In contrast, it has been assumed that long term low-level exposure to periodontal inflammation have a negative impact on metabolic control, but the pathway by which periodontitis contributes to worsening diabetes is still unclear [ 16 ].…”

Effect of antidisbiotic drugs on periodontal tissues of rats with diabetes mellitus after orthodontic tooth relocation

“…Экспериментальная медицина У больных сахарным диабетом (СД) наблюдаются серьезные изменения в организме, обусловленные нарушениями нейроэндокринной системы, развитием иммунодефицита, активацией условно-патогенной микрофлоры, существенным снижением адаптационно-трофических возможностей организма [1][2][3]. Наличие у пациентов сахарного диабета создает предпосылки для возникновения различных осложнений при стоматологических вмешательствах, в том числе, возможно, и при ортодонтическом перемещении зубов, что связано с изменениями в метаболическом обеспечении функции пародонта, включая костную ткань [4,5].…”

Influence of Oral Health on Frailty in Patients With Type 2 Diabetes Aged 75 Years or Older

“…Izuora et al reported that in diabetic patients averaged 58.9 years old, only 6.4% had their original 32 teeth and 15.3% had lost all of their teeth 9 . As periodontal disease progresses, it leads to tooth loss, and the prevalence of periodontal disease is higher in diabetics than in the general population 10 . Periodontal disease also causes systemic in ammation and adversely affects diabetes through insulin resistance 11 .…”