Periodontal disease as a complication in type 2 Diabetes mellitus – A hospital based study in Uttarakhand, India

Aims: To study the prevalence of periodontitis and its association with diabetes in patients with type 2 diabetes mellitus (T2DM). Methods: One hundred consecutive patients with T2DM and an equal number of age- and sex-matched non-diabetic controls were studied. Diabetes was diagnosed as per American Diabetes Association criteria. All subjects were evaluated for presence and severity of periodontal disease activity clinically and radiologically. Results: Prevalence of periodontitis was significantly higher in cases than in controls as per clinical attachment loss (CAL) (97% versus 34%, p<0.0001) and radiological assessment (97% versus 34%, p<0.0001). Prevalence of severe periodontitis also was higher in cases than in controls (54% versus 7%, p<0.0001). Gingival index and periodontal pocket depth were significantly higher in cases (p<0.0001each). Diabetes had a significant association with CAL (p<0.0001) and radiological damage (p<0.0001) and also with their severity (p<0.0001, p=0.0008 respectively). Severity of periodontitis had a significant association with glycated haemoglobin (HbA1c) (p=0.001), fasting blood sugar (FBS) (p=0.001) and post-prandial blood sugar (PPBS) (2h) (p=0.011). Radiological severity of periodontitis had a significant association with HbA1c (p=0.001) and FBS (p=0.01). CAL showed a significant correlation with HbA1c (r=0.708, p=0.0001), FBS (r=0.476, p=0.001), PPBS (r=0.425, p=0.001) and random blood sugar (r=0.476, p=0.001) but not with age (r=0.061, p=0.393), and duration of diabetes (r = -0.024, p=0.811). HbA1c was independently associated with severity of CAL and radiological damage both (p<0.001 each). Conclusions: Periodontitis occurs with high frequency in T2DM. Diabetes and the related parameters are associated with periodontitis as well as its severity but only HbA1c is independently associated with severity of periodontitis.