Association between Diabetic Retinopathy and Chronic Periodontitis—A Cross-Sectional Study

Veena H R,Sudhir Patil,Sribhargava Natesh

doi:10.3390/medsci6040104

Abstract

Periodontal disease (PD), a chronic inflammatory condition characterized by destruction of the supporting tissues of the teeth, increases the risk of complications in diabetics. Diabetic retinopathy (DR) is a microvascular complication of prolonged hyperglycaemia. There appears to be a similarity in the pathogenesis of DR and PD. Hence, this study aimed to investigate the association, if any, between DR and PD, correlate the severity of DR with the severity of PD, and investigate the association between glycated haemoglobin (HbA1c), serum creatinine and periodontal variables. The periodontal status of 200 adult diabetic patients in the age group of 30–65 years with varying severity of DR was assessed. Evaluation of the severity of PD was assessed by recording clinical parameters. Haematological investigations including glycated haemoglobin (HbA1c) and serum creatinine were estimated before the initiation of treatment for DR. A statistically significant association between the mean duration of diabetes mellitus (DM) and the severity of DR and PD was found. The severity of PD was directly correlated with the severity of DR. There was a significant association between the levels of HbA1c and serum creatinine and severity of DR and PD. There could be a plausible relationship between DR and PD. Further prospective studies on a larger population with longer follow-ups are required to ascertain whether PD and its severity directly affect the progression and severity of DR.

Highlights

Diabetes mellitus (DM) is a metabolic disorder marked by high levels of blood glucose resulting from a defect in insulin production, insulin action or both
According to the recently published ICMR–INDIAB diabetes prevalence study, the overall prevalence of diabetes mellitus (DM) in India is estimated to be 7.3% and the prevalence of pre-diabetes 10.3% based on the world health organization (WHO) criteria or 24.7% based on the American dental association ADA criteria [3]
As this is a cross-sectional study with a limited sample size, a probable cause and effect relationship between Periodontal disease (PD) and Diabetic retinopathy (DR) cannot be established

Summary

Introduction

Diabetes mellitus (DM) is a metabolic disorder marked by high levels of blood glucose resulting from a defect in insulin production, insulin action or both. The complications of prolonged hyperglycaemia can be classified into macrovascular (coronary artery disease, peripheral arterial disease, and stroke) and microvascular (nephropathy, neuropathy, and retinopathy) [1]. According to the world health organization (WHO), the prevalence of DM in adults worldwide was estimated to be 4% in 1995 and is predicted to rise to 5.4% by 2025 [2]. Diabetes mellitus is beginning to appear much earlier in life, and chronic long-term complications are becoming more common [4]. Diabetic retinopathy (DR), a microvascular complication of chronic DM, is estimated to be the most frequent cause of new cases of blindness among adults aged 20–74 years [5]. It is estimated that almost half of the world’s population of diabetics will develop a degree of DR at some point in their

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