Abstract
Severe periodontitis is a risk factor for poor glycemic control. The appropriate medical treatment and plaque control of periodontitis positively affects blood-sugar control in diabetes patients. We aimed to identify the factors associated with glycemic control and examine the periodontal treatment (PT) experience and oral health-related quality of life (OHQoL) for patients with poor glycemic control in type 2 diabetes mellitus (T2DM). This multicenter case–control study recruited 242 patients with poor glycemic control and 198 patients with good glycemic control. We collected patients’ information through face-to-face interviews using a structured questionnaire. The Oral Health Impact Profile-14 (OHIP-14) was used to measure OHQoL. Based on PT status, the patients were classified into three groups: a non-periodontal disease group, a PT group, and a non-PT (NPT) group. Regression models were used to analyze the data. No interdental cleaning (adjusted odds ratio (aOR) = 1.78) and positive attitudes toward periodontal health (aOR = 1.11) were significantly more likely to be associated with poor glycemic control in patients with T2DM. The PT group had a significantly lower OHIP-14 score than the NPT group (6.05 vs. 9.02, p < 0.001), indicating a better OHQoL among patients with poorly controlled T2DM. However, the OHQoL did not differ significantly in patients with well-controlled T2DM between the PT and NPT groups. This suggested that diabetic patients with poor glycemic control must improve periodontal care practices and receive proper PT, if necessary, to improve their OHQoL.
Highlights
Diabetes is a systemic and irreversible disease that has become an increasingly crucial public health concern worldwide
We found a significant difference in the oral health-related quality of life (OHQoL) between the periodontal treatment (PT) and NPT groups among patients with poor glycemic control; no significant difference was noted in any of the domains of OHIP-14T between the PT and non-periodontal disease (NPD) groups
Our results demonstrated that periodontal disease was correlated with physical pain in patients with type 2 diabetes mellitus (T2DM) and periodontal disease, corroborating the findings of studies that have not focused on patients with diabetes [14,36]
Summary
Diabetes is a systemic and irreversible disease that has become an increasingly crucial public health concern worldwide. The global prevalence of diabetes in 2017 was approximately 425 million (8.8%) and is expected to rise to 629 million by 2045 [1]. Adults aged 20–79 years have diabetes [1]. In 2017, diabetes ranked fifth among the 10 leading causes of death; deaths caused by diabetes account for approximately 5.7% of all deaths [2]. Improper care can result in numerous complications such as cerebrovascular disease [3], cardiovascular disease [4], kidney disease [5], diabetic retinopathy [6], and peripheral neuropathy [7]; it may lead to blindness, dialysis, and amputation. A history of severe hypoglycemia and hyperglycemia (“severe dysglycemia”) and the burden of diabetes complications are independent risk factors for repeat hospitalizations [8]. The type 2 diabetes mellitus (T2DM) patients with a glycated hemoglobin level (HbA1c) ≤ 6.5% were more likely to have a good-excellent quality of life (QoL) as compared with those with an HbA1c level > 6.5% [9]
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