Periodontal disease in patients with diabetes mellitus attending Kiruddu National referral Hospital: Prevalence, risk factors, association with glycemic control and insulin resistance

Abstract

Background: Diabetes mellitus and periodontal disease establish a relationship where one if poorly managed complicates the management of the other. This study set out to describe the association between periodontal diseases and diabetes mellitus among adults in Uganda. Methods: This study was conducted under four sub-studies. 1) A cross-sectional study to determine the prevalence and factors associated with periodontal diseases. 2) a prospective cohort to determine the effect of periodontal treatment on glycemic control. 3) A case-control study to describe the oral microbiome associated with periodontal diseases and 4) A cross sectional study to describe the association between periodontitis and insulin resistance in adults attending Kiruddu hospital. The data were analyzed using R studio. Significance for the statistical tests was set at 0.05. Results: The study identified the following: 1) There was a high prevalence of periodontal diseases (85.2%) in patients with diabetes mellitus in Uganda especially in participants with no formal education (p=.04). 2) The diabetic status was significantly associated with a change in the oral microbiome of the periodontal pockets (p=.001). 3) Non-surgical periodontal treatment was not associated with a decrease in HbA1c levels three months after this intervention. 4) Periodontitis was significantly associated with a high triglyceride glucose index (p=.03). Conclusion: Periodontal diseases complicate the management and prognosis of diabetes mellitus through its effects on glycemic control and insulin resistance while diabetes mellitus may predispose patients to more prevalent and severe forms of periodontal diseases by altering the sub gingival microbiome. Recommendation: Oral health education and care should be considered in the management all patients with diabetes mellitus in Uganda. There is a need to conduct further studies to determine the effect of periodontal treatment on insulin resistance and glycemic control.