Journal of the American Dental Association (1939) · 2026
Glycated hemoglobin levels in participants with diabetes and oral disease enrolled in the All of Us Research Program.
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Jurasic M Marianne, McDonough Robert, Kaye Elizabeth, Gibson Gretchen
Аннотация
BACKGROUND: Type 2 diabetes mellitus (T2DM) increases the risk of developing periodontal disease, and severe periodontal disease leads to poor diabetic control based on blood levels of glycated hemoglobin (HbA1c). However, less is known about diabetic control and caries. The authors aimed to compare HbA1c levels in a cohort of All of Us Research Program study participants with T2DM who had received a diagnosis of caries, gingivitis, or periodontitis.
METHODS: Included in this cross-sectional study were people who received a diagnosis of T2DM; a mutually exclusive diagnosis of caries, gingivitis, or periodontitis; and an HbA1c laboratory value within plus or minus 90 days of receiving the dental diagnosis. The primary outcome was the level of diabetic control dichotomized into controlled (HbA1c ≤ 64 mmol/mol [8%]) and uncontrolled (HbA1c > 64 mmol/mol [8%]). Covariates included demographic charactersitics, body mass index, smoking history, and self-reported general health. Differences between exposure groups were tested using t tests and χ2 tests and logistic regression modeled diabetic control at the time of dental disease diagnosis.
RESULTS: The analytic data set included 2,421 participants. Mean (SD) age at diabetes diagnosis was 52.3 (12.0) years; 50.8% of participants were women, 27.7% were Black, 35.6% were White, 29.2% were Hispanic, and approximately 50% reported annual household income less than $25,000. Participants who received a diagnosis of caries had higher mean HbA1c levels. Participants who received a diagnosis of gingivitis or periodontitis were more likely to have controlled T2DM than those who received a diagnosis of caries.
CONCLUSIONS: The study results underscore the need for further research to clarify the association between caries and diabetes.
PRACTICAL IMPLICATIONS: Although it is widely accepted that a bidirectional association exists between T2DM and periodontal disease, increased awareness among health care professionals of other oral-systemic associations is warranted.
METHODS: Included in this cross-sectional study were people who received a diagnosis of T2DM; a mutually exclusive diagnosis of caries, gingivitis, or periodontitis; and an HbA1c laboratory value within plus or minus 90 days of receiving the dental diagnosis. The primary outcome was the level of diabetic control dichotomized into controlled (HbA1c ≤ 64 mmol/mol [8%]) and uncontrolled (HbA1c > 64 mmol/mol [8%]). Covariates included demographic charactersitics, body mass index, smoking history, and self-reported general health. Differences between exposure groups were tested using t tests and χ2 tests and logistic regression modeled diabetic control at the time of dental disease diagnosis.
RESULTS: The analytic data set included 2,421 participants. Mean (SD) age at diabetes diagnosis was 52.3 (12.0) years; 50.8% of participants were women, 27.7% were Black, 35.6% were White, 29.2% were Hispanic, and approximately 50% reported annual household income less than $25,000. Participants who received a diagnosis of caries had higher mean HbA1c levels. Participants who received a diagnosis of gingivitis or periodontitis were more likely to have controlled T2DM than those who received a diagnosis of caries.
CONCLUSIONS: The study results underscore the need for further research to clarify the association between caries and diabetes.
PRACTICAL IMPLICATIONS: Although it is widely accepted that a bidirectional association exists between T2DM and periodontal disease, increased awareness among health care professionals of other oral-systemic associations is warranted.