PERIO - Periodontal Practice Today 5 (2008), No. 4 4. June 2009
PERIO - Periodontal Practice Today 5 (2008), No. 1 (03.04.2008)
Metabolic control, oral microbiological and periodontal conditions in patients with diabetes mellitus
Mattheos, Nikos / Kandylaki, Maria / Lang, Niklaus P. / Persson, G. Rutger / Salvi, Giovanni E.
Aim:To investigate the relationships between metabolic control, duration of disease, type of dia-betes, diabetes-related complications, and microbiological and clinical periodontal conditions in sub-jects who have diabetes mellitus.
Study design:A cross-sectional analysis of clinical and microbiological periodontal conditions was per-formed in 41 subjects with diabetes mellitus, untreated for any form of periodontal disease.
Results:Twenty-seven subjects with type 1 diabetes mellitus (T1DM) and 14 with type 2 (T2DM)(mean duration, 17.4 years [SD 9.3], and 11.7 years [SD 4.2], respectively) were studied. The meanserum values of glycosylated haemoglobin (HbA1c) did not differ between the two groups (T1DM,7.7% [SD 1.8]; T2DM, 8.0% [SD 0.9]). Medical complications were present in 45% of the T1DMand in 71% of the T2DM subjects. Gingivitis was not correlated with mean HbA1c levels in T2DMsubjects, but was negatively correlated with the T1DM group (r2= 0.19, Pearson's coefficient r = - 0.43, p < 0.02). The presence of bacteria in periodontal pockets differed with T1DM and T2DMstatus for Campylobacter ochracea,Peptostreptococcus micros,Porphyromonas gingivalisandSelenomonas noxia. Oral bacterial load was not linked to serum HbA1c levels or the presence of diabetes-related complications.
Conclusions:Gingivitis was common and similar in both T1DM and T2DM subjects. Serum HbA1c lev-els were not related to the levels of the subgingival microbiota in T2DM, but negatively correlated withthe extent of gingivitis in T1DM. P. gingivalisappeared to be more prevalent in T2DM subjects.
Keywords: diabetes mellitus, metabolic control, oral microbiology, periodontal disease