Diabetes & periodontitis

04.01.2022

PD Dr. Kristina Bertl, PhD MSc MBA

A systematic review and meta-analysis of epidemiologic observational evidence on the effect of periodontitis on diabetes
Filippo Graziani, Stefano Gennai, Anna Solini & Morena Petrini

Diabetes mellitus and periodontitis are two of the most common chronic diseases. Diabetes mellitus affects approximately 415 million people worldwide, and periodontitis affects as many as 750 million. Furthermore, these two diseases mutually affect each other, and periodontitis constitutes one of the main complications of diabetes. But what exactly is the current situation among patients with periodontitis and/or type 2 diabetes mellitus?

Compared with periodontally healthy patients, patients who have periodontitis but do not have diabetes exhibit ...
... higher HbA1c values (= poorer long-term blood sugar values), a higher fasting blood sugar level and a higher prevalence of pre-diabetes.
... an approximately 20–30% higher risk of also developing diabetes later on.

Compared with periodontally healthy diabetics, patients who have diabetes and periodontitis exhibit ...
... higher HbA1c values (= poorer long-term blood sugar values).
... a higher rate of diabetes-related complications.

Accordingly, it is important to explain these links to our patients: 1) patients with periodontitis should be made aware that they have a higher risk of also developing diabetes, particularly if they have certain additional risk factors (e.g. cases of diabetes in the family, excess weight, poor diet etc.), and 2) as a result of their periodontitis, patients with diabetes can have poorer control of their blood sugar levels and increased diabetes-related complications.

Tip!
The HbA1c value indicates the patient’s blood glucose level in the past 8–12 weeks. It is therefore an important measurement in diabetes management for monitoring blood sugar levels, which our patients should also be aware of. To achieve an acceptable blood sugar level, a person with diabetes should aim to keep this value below 7.5% or 58 mmol/mol; as a comparison, the value in a non-diabetic is approx. 5% or 30 mmol/mol.

Reference

Graziani F, Gennai S, Solini A, Petrini M. A systematic review and meta-analysis of epidemiologic observational evidence on the effect of periodontitis on diabetes. J Clin Periodontol. 2018;45:167–187. https://doi.org/10.1111/jcpe.12837