Relationship Between Periodontal Disease and Glycemic Control in Pediatric Patients with Type 2 Diabetes Mellitus

Abstract

IntroductionType 2 Diabetes Mellitus (T2DM) is a disease of heterogeneous etiology, in which the patient presents alterations in metabolism, which are associated with a total or relative deficiency in insulin production and variable degrees of resistance to it1,2.T2DM and periodontal disease are chronic diseases, the evidence suggests an association between the two. Studies report that T2DM worsens the periodontal disease and glycemic control plays a fundamental role in this3.4.ObjectiveTo determine the relationship between periodontal disease and glycemic control in pediatric patients with T2DM.MethodologyAn observational, descriptive, cross‐sectional, prospective, homodemic and single‐center study was carried out in the pediatric stomatology service of the “Hospital para el Niño Poblano” (Puebla city, Mexico) in the period January‐July 2019 with 20 patients (between 6 to 18 years old) diagnosed with T2DM and were under treatment for their glycemic control.ResultsThe population was classified into patients with glycemic control based on glycated hemoglobin (HbA1c ≤ 7.5%) and patients without glycemic control (HbA1c> 7.5%).The prevalence of periodontal disease for patients diagnosed with T2DM was higher in uncontrolled patients who were classified within high Community Periodontal Index (CPI) codes between 3 (71.4%) and 4 (28.6%)5(Table 1).Similarly, it was observed that in the group of patients without glycemic control presented averages of Simplified Oral Hygiene Index (OHI‐S) cataloged between fair (57.1%) and poor (42.9%) (Table 2).DiscussionSimilar results were obtained by Janket (2005)6and Carneiro (2015)7, who relate a higher rate of periodontal disease in patients with higher HbA1c values.ConclusionIt was determined a relationship between glycemic control and periodontal disease in children, because patients with poor glycemic control (HbA1c> 7.5%) presented CPI with degrees of inflammation and presence of periodontal pockets and poor OHI‐S.References Islas S, Revilla MC. Diabetes Mellitus: Actualizaciones. IMSS. México, D.F.: Editorial Alfil. 2013. Menon S, Francis J, Zdraveska N, Dusabimana A & Bhattacharyya S. La epidemiología de la hiperglucemia inducida por TB intransitoria en individuos con diabetes mellitus 2 no diagnosticada previamente: un protocolo para una revisión sistemática y un metanálisis. Revisiones sistemáticas. 2019; 8 (1): 1‐5. Britos MR, Sin CS, & Ortega SM. Enfermedad periodontal y su implicancia en la diabetes mellitus: revisión de la literatura. Rev. Ateneo Argent. Odontol. 2019: 33‐40. Pérez I. Diabetes Mellitus. Gac Med Mex. 2016;152(1):50‐55. IPC. OMS (online, July 2019). URL available at: https://es.scribd.com/doc/84956710/Indice‐Periodontal‐de‐Russell‐forma‐OMS Janket S, Wightman A, Baird AE, Van Dyke T, Jones J. Does periodontal treatment improve glycemic control in diabetic patients? A meta‐analysis of intervention studies. J Dent Res. 2005;84(12):1154‐1159. Carneiro V, Calixto F, Morais F, Pegoretti T, Borges AC, da Silva M. The influence of glycemic control on the oral health of children and adolescents with diabetes mellitus type 1. Arch Endocrinol Metab. 2015;59(6):535‐540.