Is Gum Disease a Marker for Diabetes?

According to a recent article from Medical News Today, researchers have discovered that severe gum disease, or periodontitis, may be an early marker for type 2 diabetes. Additionally, they also suggested that a simple diabetes screening procedure, involving a finger prick, could be administered at the dental office, allowing for early diagnosis and better treatment.

Scientists from the University of Amsterdam in The Netherlands studied 313 individuals from a dental clinic at the university. Of those participants, 126 had mild-to-moderate gum disease, 78 had severe periodontitis, and 198 patients did not have signs of gum disease. Those with periodontitis had a higher body mass index (BMI) than the others, with an average BMI of 27. Other risk factors for diabetes, including high blood pressure and high cholesterol, were similar across all three groups.

The researchers analyzed higher glycated hemoglobin (HbA1c) in dry blood spots, evaluating the differences in mean HbA1c values. They also considered the prevalence of diabetes and prediabetes between the two groups. HbA1c values measure the average blood sugar level in the last 2-3 months, and the dry blood spots were obtained by using a finger pin-prick test. Prediabetes is typically considered to range between an HbA1C value of 39-47 millimoles per mol (mmol/mol).

The analysis showed that those with the most severe form of periodontitis also had the highest HbA1c values. The average values for the severe gum disease group was 45 mmol/mol, compared to 43 mmol/mol with mild-to-moderate gum disease and 39 mmol/mol for those without the oral disease. Researchers also found a high percentage of patients with suspected diabetes and prediabetes among those with mild-to-severe gum disease, but found undiagnosed cases across all three groups. In fact, as much as 18% of those with severe gum disease had not been diagnosed with diabetes.

Because the study is observational, there is no causal link explained in the findings. However, the researchers suggested that screening patients with severe periodontitis for diabetes as a regular practice might be an effective way of avoiding complications of the disease.

“[The findings confirm] the assumption that severe periodontitis could be an early sign of undiagnosed diabetes […] The early diagnosis and intervention of prediabetes prevent the common microvascular and macrovascular complications and are cost-effective.”

According to the latest data, approximately 422 million people around the world are affected by diabetes. In the United States alone, 29 million people have the disease. Of these, more than 8 million have it but haven’t been diagnosed. The Centers for Disease Control and Prevention also estimates that 37% of American adults over the age of 20 have prediabetes.