Periodontitis presage pre-diabetes – a comparative study of glycemic control in non-diabetic population with and without periodontal disease

Introduction and Aim: The understanding of the etiology and pathogenesis of periodontal diseases and their chronic, inflammatory and infectious nature suggests that these infections may influence events elsewhere in the body. Poorly controlled diabetes is a well-recognized risk factor for developing periodontal disease. There is also ample evidence that periodontal disease can worsen a patient’s glycemic control and proper management of periodontal disease can improve the same. However, very few have determined effect of periodontitis on glycemic control, of non-diabetic population and concluded that untreated periodontitis pose a risk of pre-diabetes in systemically healthy individuals. The purpose of this study is to estimate and compare the HbA1c levels in non-diabetic subjects with periodontitis and periodontally healthy controls. Materials and Methods: A total of 639 non-diabetic subjects were selected for the study and were divided into 2 groups based on the periodontal status: Group A (n = 324) Periodontally Healthy controls months and Group B (n = 315) subjects with Chronic periodontitis. Clinical parameters like Plaque index (PI), Modified sulcular bleeding index (mSBI), Probing depth (PD), and Clinical attachment level (CAL) were measured. Glycemic control was measured by assessing HbA1c. Results: The mean PI for Group A was 0.99 ± 0.38 and Group B was 1.9 ± 0.59. mSBI score for the test group was 2.9 ± 0.87 and it was 1.79 ± 0.57 in the control group. The mean PD in the Group A was 2.73 ± 0.9 and in Group B was 7.16 ± 0.93. The mean CAL for Group A was 2.24 ± 0.65 and in Group B was 5.86 ± 0.75. The values for all the clinical parameters were statistically significant. The mean HbA1c% for control group was 2.94 ± 0.29 and for the test group was 5.95 ± 0.36. This value was statistically significant between the two groups. Conclusion: In a non-diabetic systemically healthy population, the glycated hemoglobin level of the subjects with severe periodontitis is significantly greater than the subjects without periodontitis. Non-diabetic subjects with severe periodontal disease presented a pre-diabetic state reflecting that periodontal disease has created a state of insulin resistance.