Abstract
To evaluate the association between dental visits and variation in the glycated hemoglobin index (A1C) of patients with type 2 diabetes (T2DM) with well or not well glycemic control over time. Patients with T2DM, A1C ≥ 7% (not well-controlled) and < 7% (well-controlled), who attended a primary care service and were followed up from January 2010 to May 2018. The outcome was the variation of A1C obtained from reference laboratories. At the beginning of the study, a questionnaire with behavioral, clinical, and socioeconomic information was carried out. Multiple linear regression analyses tested interaction terms of all variables with the initial glycemic level (not well-controlled or well-controlled). The sample consisted of 507 people, 65% women, and 66% individuals 55 to 74 years old, followed on average for 5.4 years. There was an interaction (p = 0.01) between dental visits and initial A1C. Patients not well-controlled with at least one dental visit had an average reduction in A1C of -0.56 percentage point (95%CI -1.06 - -0.56), whereas the well-controlled group who also had at least one dental visit had an increase of 0.34 percentage point (95%CI -0.18 - 0.87). Dental visits were associated with an improvement in A1C of approximately a half-percentage point in patients who had the initial A1C considered as not well-controlled.
Highlights
The global prevalence of Diabetes Mellitus (DM) has greatly increased over the last decades, especially in low and middle-income countries[1]
Considering Primary Health Care as an essential setting to promote the health of patients with Type 2 Diabetes Mellitus (T2DM), in which oral care is included, the present study aims to evaluate the association between dental visits and variation in the glycated hemoglobin index (A1C) of patients with type 2 diabetes (T2DM) with well or notwell glycemic control over time
The present study showed that patients with initial A1C considered not well-controlled and who visited the dentist had an average reduction of approximately half percentage point in A1C
Summary
The global prevalence of Diabetes Mellitus (DM) has greatly increased over the last decades, especially in low and middle-income countries[1]. Both the disease and its complications or comorbidities are important risk factors, causing deaths worldwide[2]. According to the Global Disease Burden Study, the participation of Type 2 Diabetes Mellitus (T2DM) was the most significant among the chronic non-communicable diseases in the Brazilian epidemiological scenario in 2008, ranking among the top five disorders of the disease burden in the country[3]. The treatment of a patient with T2DM aims to maintain adequate blood glucose levels since chronic hyperglycemia is associated with micro and macrovascular complications[5]. Several oral diseases have been reported in these patients, as greater severity and prevalence of periodontitis[6,7,8], more tooth loss[6,9], higher caries index[10,11], increased prevalence of candidiasis[12], xerostomia[12], and oral cancer[6]
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