The Periodontitis-Diabetes Link Goes Both Ways The Periodontitis-Diabetes Link Goes Both Ways

Researchers published the study covered in this summary on Research Square as a preprint that has not yet been peer-reviewed.

Key Takeaways

  • The association between type 2 diabetes and periodontitis was bidirectional in a retrospective cohort study of a representative sample of Taiwanese adults older than 40 years old followed for 15 years.

  • The rate of incident type 2 diabetes significantly increased in the patients with periodontitis compared to those without periodontitis. And in the same population during the same observation period, people with type 2 diabetes had a significantly increased rate of developing periodontitis compared to those without diabetes.

Why This Matters

  • The incidence of type 2 diabetes constitutes a pandemic, while periodontal disease is the world’s most prevalent inflammatory disease with nearly 800 million cases of severe periodontitis recorded worldwide in 2017.

  • Some prior reports documented bidirectionality between these two conditions, but earlier findings were inconsistent.

Study Design

  • The study used data collected in Taiwan’s Longitudinal Health Insurance Research Database in 2000-2015. The database includes a random sample of about 1 million beneficiaries, roughly 5% the Taiwanese population.

  • Researchers identified 11,011 people with incident periodontitis during the study period who then underwent treatment for their disease, and an age, sex, and index-date matched group of 11,011 people with incident periodontitis during the study period who did not receive treatment. They also identified a third group of 11,011 matched individuals who did not develop periodontitis during the study period. All three groups excluded those with diabetes during the 2 years prior to 2000 or prior to the diagnosis of periodontitis in 2000-2015, as well as those who were younger than 40 years old in 2000.

  • The study also included 157,798 people with type 2 diabetes and 157,798 matched controls without diabetes in 2000-2015. These groups excluded people with periodontitis during the 2 years prior to 2000, those whose diabetes was incident during the 2 years prior to 2000, and those who were younger than 40 years old in 2000.

Key Results

  • By the end of 2015, 7.0% of those with incident treated periodontitis, 6.0% of those who developed periodontitis (untreated), and 4.5% of controls without periodontitis developed type 2 diabetes.

  • The adjusted hazard ratios for developing type 2 diabetes were 1.94 in those with treated periodontitis and 1.72 in those with untreated periodontitis. Both hazard ratios were significant.

  • By the end of follow-up, 1.05% of those with type 2 diabetes developed periodontitis compared with 0.27% of those without diabetes, a significant difference.

  • Compared with those who did not have type 2 diabetes, the adjusted hazard ratio for incident periodontitis in the diabetes group was 1.99, a significant difference.

Limitations

  • Data on the severity of periodontitis were unavailable.

  • The dataset did not include data on genetic, psychosocial, and detailed environmental factors.

  • The data did not include information on the metabolic or diabetic state of the included individuals.

  • The number of people with untreated periodontitis was small.

Disclosures

This is a summary of a preprint research study, “Bi-directional association between type 2 diabetes and periodontitis in the nationally representative sample comprising Taiwanese adults from 2000 to 2015,” written by researchers at four centers in Taiwan on Research Square provided to you by Medscape. The preprint has not yet been peer-reviewed. The full text can be found on researchsquare.com.