ASSOCIATION BETWEEN PERIODONTITIS AND MICROVASCULAR COMPLICATIONS AMONG PATIENTS WITH TYPE 2 DIABETES MELLITUS

Petch Rawdaree1, Chanita Tantipoj2, Pirasut Rodanant2

Abstract

Periodontitis and microvascular diseases are commonly found in poorly controlled type 2 diabetes mellitus (DM). In this study, we aimed to evaluate the association between periodontitis and the microvascular complications of DM in order to determine if diabetics with periodontitis should be screened for the presence of microvascular disease. We recruited diabetic patients who attended the Endocrinology Unit, Department of Medicine, Vajira Hospital, Navamindradhiraj University, Bangkok, Thailand during May-July 2018. Inclusion criteria were: 1) DM patients aged ?30 years who had the results of a HbA1c test during the previous month, 2) who had been evaluated for a diabetic microvascular complication defined as having either diabetic nephropathy (DN) (defined as having an estimated glomerular filtration rate or eGFR ?60 ml/min/1.73 m2 or a urine microalbumin level >30 mg/g urine) or diabetic retinopathy (DR) (defined as having non-proliferative diabetic retinopathy (NPDR) or proliferative diabetic retinopathy (PDR) found on non-mydriatic retinal photography by an ophthalmologist during the previous 12 months), and 3) having ?6 teeth in 2 quadrants in diagonal positions. Subjects were excluded if they were critically ill or had a condition making a dental examination difficult. Demographic data, HbA1c levels, laboratory blood-test results, duration of DM and presence of microvascular complications were obtained from their medical charts. Subjects were examined for periodontitis by measuring: 1) probing depth (PD), 2) clinical attachment level (CAL), and 3) bleeding on probing (BoP). A total of 184 subjects were included in this study; 40% male. The mean (±standard deviation (SD)) age of study subjects was 59.9 (±10.4) (range: 31-88) years. The mean (±SD) HbA1c levels among those with and without complications were 8.8 (±2.1) and 7.8 (±1.8), respectively (p=0.002). The mean (±SD) CALs among patients with and without complications were 3.6 (±1.1) mm and 3.3 (±1.0) mm, respectively (p>0.05). The mean (±SD) PDs among those with and without complications were 2.5 (±0.6) and 2.5 (±0.6), respectively (p=0.75). About one-fourth (24.5%) of subjects had microvascular complications of DM and 88.0% had moderate-to-severe periodontitis. On logistic regression analysis periodontitis was not significantly associated with microvascular complications (p>0.05). In our study population, there was no significantly association between periodontitis and microvascular complications of diabetes; therefore, screening DM patients with periodontitis for microvascular complications is not warranted.