Association Between Periodontal Disease Severity and Glycemic Control in Patients with Type 2 Diabetes Mellitus
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Background: Type 2 diabetes mellitus and periodontal disease are interconnected chronic conditions linked through inflammatory and metabolic pathways. Prolonged hyperglycemia promotes the formation of advanced glycation end products and increases pro-inflammatory cytokine release, accelerating periodontal tissue breakdown. Untreated periodontal disease can increase systemic inflammation and negatively affect glycemic regulation. Objective: To determine the association between periodontal disease severity and glycemic control in patients with type 2 diabetes mellitus and to examine whether poor glycemic control predicts greater periodontal tissue loss. Methodology: A cross-sectional analytical study was conducted among 120 adults with type 2 diabetes mellitus. Periodontal status was evaluated using the Community Periodontal Index, probing pocket depth, and clinical attachment level. Glycemic control was assessed using glycated hemoglobin values extracted from medical records. Patients who had any systemic disease that directly affects periodontal tissues, such as rheumatoid arthritis or connective-tissue disorders, were excluded. We also excluded pregnant females and patients who had periodontal treatment in the past three months to avoid changes in baseline readings. Data were analyzed using Pearson’s correlation and multivariate linear regression adjusting for age, gender, smoking status, duration of diabetes, and oral hygiene practices. Results: Among the 120 participants (mean age 52.7±8.6 years), 65% had poor glycemic control (HbA1c ≥8%). Patients with poor control exhibited significantly higher mean PPD (5.0±1.1 mm) and clinical attachment level (4.7±1.0 mm) compared with those having HbA1c <7% (PPD 3.5±0.8 mm; clinical attachment level 3.1±0.9 mm) (p<0.001). HbA1c demonstrated a moderate positive correlation with CAL (r=0.43, p<0.001). On multivariate regression, HbA1c remained an independent predictor of periodontal destruction (β=0.37, p<0.01) after adjusting for confounders. Conclusion: Poor glycemic control is significantly associated with increased periodontal disease severity among Pakistani patients with type 2 diabetes mellitus. Incorporating periodontal assessment and treatment into diabetes management programs may help improve overall health outcomes.
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