The Relationship of HbA1c Serum Levels with the Severity of Periodontal Disease in Patients with Type 1 Diabetes Mellitus: A Cross-Sectional Study.

Abstract

Objective:  According to the evidence, the level of glycemic control is of key importance in determining the increased risk of periodontal disease (PD). The aim of the study was to evaluate the role of metabolic control as a key factor leading to the development and severity of periodontitis and compare the periodontal and oral hygiene status with the glycated hemoglobin levels.

Materials and methods:  The evaluation was undertaken with diabetic patients (59 uncontrolled diabetics and 36 controlled diabetics) from a patient cohort of the Hospitalar Center of Tâmega e Sousa and subjects without diabetes (n = 95).

Statistical analysis:  The data were analyzed using IBM SPSS Statistics software (Statistical Program for Social Sciences), version 29.0 for Windows. In the logistic regression analysis, odds ratios (ORs) and 95% confidence intervals (CIs) were calculated. The significance level was set at 0.05.

Results:  Periodontal parameters were increased in systemically compromised individuals especially those who were poorly controlled as compared with their healthy counterparts, which are important indicators of PD progression. Furthermore, uncontrolled type 1 diabetic mellitus (T1DM) patients showed increased plaque index (PI), which predisposes these individuals to a greater degree of periodontal destruction and tooth loss. Using a binary logistic regression, we observe a significant relation of the risk of severe periodontitis in T1DM subjects with family history of T1DM (p = 0.019; OR: 3.36; 95% CI: 1.22-9.21), alcohol consumption (p = 0.02; OR: 3.78; 95% CI: 1.23-11.63), periodontal probing depth (PPD) (p < 0.001; OR: 3.64; 95% CI: 14.74-90.34), and clinical attachment loss (p = 0.033; OR: 4.71; 95% CI: 1.13-19.59).

Conclusion:  Increased glycated hemoglobin levels were positively related with periodontal status. Uncontrolled systemically compromised individuals showed an increased Plaque index (PI), which predisposes to greater periodontal inflammation and tooth loss. Increased clinical attachment level, Periodontal probing depth (PPD) and family history of T1DM, and alcohol consumption were identified as potential risk factors for severe periodontitis in subjects with T1DM.