Edentulismo, periodontite e controle glicêmico em diabéticos do tipo 2 : um estudo transversal

Abstract

The role of periodontal disease on sugar control and vice versa has been subjected to numerous investigations. The above association seems to be bi-directional. Within this context, it is logical to argue that those without teeth have better control of their sugar levels as edentulousness removes the periodontal disease associated infection and inflammation. To test this hypothesis, we conducted a cross-sectional study among Brazilian adults. The aim of this study was to compare the glycemic levels of type 2 diabetic subjects edentulous with dentate one with or without periodontitis. Methods: Demographic information, medication history, clinical and fasting blood glucose (FBG) information were collected from medical/dental records of non-smoking subjects with healthy periodontal tissues or mild periodontitis (NO/MILD - N=96), moderate periodontitis or severe periodontitis (MOD/SEV - N=74) and those who were edentulous (N=141). All patients had a medical diagnosis of type 2 diabetes and were taking at least one of the following medications: metformin, glinbenclamide and insulin. Clinical periodontal exam was performed using a 15 mm periodontal probe and patients were classified according to CDC/AAP Classification. FBG levels were evaluated among groups while controlling for age, gender, medication history and periodontal diseases using regression analysis. Results: Mean (SD) FBG levels (mg/dL) among groups were NO/MILD = 123,15 (36,77); MOD/SEV = 136,61 (33,83) and edentulous = 155.7 (70.9). Thirteen percent of the variance in FBG levels were explained by age, gender, number of medications taken and periodontal status (p<0.0001). These covariates were significant predictors of FBG levels. Post-hoc test has also shown that the subjects of the MOD/SEV group have increased FBG levels than the ones in the NO/MILD group. Conclusions: Edentulous patients presents more glycemic levels than the dentate ones. Among the dentates subjects, the greater the severity of periodontal disease, the higher will be glycemic levels.