May 27, 2008
Researchers have long noted that people with Type 2 diabetes are at higher risk for periodontal disease. The thinking is periodontal disease must be a consequence of Type 2 diabetes. But when one digs deeper, the scientific literature is relatively quiet in building a case for this proposed relationship. This leaves the door open for another hypothesis: Is it possible that periodontal disease contributes to the development of Type 2 diabetes? The hypothesis builds on two points: Diabetes is now often characterized as a cardiovascular disease, and periodontal disease has long been considered a possible risk factor for cardiovascular disease.
To take a look at this question, NIDCR grantees and colleagues turned to existing data from the first National Health and Nutrition Examination Survey (NHANES I), conducted in the early 1970s. They teased out 9,296 adult participants who reported no history of Type 2 diabetes and categorized them based on the level, if any, of periodontal disease. They then compared the risk of developing diabetes over the next 20 years between people with and without periodontal disease. After adjusting their analyses for other diabetes risk factors, the researchers determined that NHANES I volunteers with intermediate periodontal disease at baseline were twice as likely to develop diabetes as healthy participants. The risk also remained elevated for those with advanced periodontal disease. Moreover, when considering tooth loss as a surrogate for historical periodontal disease, they found that participants with advanced tooth loss had 70 percent greater odds of developing diabetes. Interestingly, for edentulous volunteers, the odds of diabetes were increased by only 30 percent relative to participants with minimal tooth loss.
Read more about this study by Demmer RT, Jacobs DR Jr, and Desvarieux M, which was published online in Diabetes Care on April 4.