Background: Chronic periodontitis (CP) and diabetes mellitus (DM) share a bidirectional relationship. Poor glycemic control accelerates periodontal destruction, while periodontitis exacerbates systemic inflammation, impacting glycemic regulation. This study evaluates the correlation between glycemic control, measured by fasting blood sugar (FBS) and glycated hemoglobin (HbA1c), and the severity of periodontitis. Additionally, it examines the prevalence of undiagnosed diabetes among periodontitis patients.
Materials and Methods: A cross-sectional observational study was conducted on 150 patients diagnosed with chronic periodontitis. Participants underwent a comprehensive periodontal examination, including Plaque Index (PI), Gingival Index (GI), Probing Pocket Depth (PPD), Clinical Attachment Loss (CAL), and radiographic assessment. Blood samples were collected for FBS and HbA1c measurements. Patients were categorized into diabetic (HbA1c ≥6.5%), prediabetic (HbA1c 5.7%–6.4%), and non-diabetic (HbA1c <5.7%) groups. Statistical analysis assessed the correlation between glycemic markers and periodontal disease severity.
Results: The study revealed a significant positive correlation between poor glycemic control and chronic periodontitis severity. The mean PPD and CAL values were highest in the diabetic group (4.98±0.64 mm and 5.42±1.12 mm, respectively), followed by the prediabetic (4.23±0.52 mm and 4.76±0.98 mm) and non-diabetic groups (3.65±0.48 mm and 3.92±0.86 mm) (p<0.001). HbA1c levels showed a strong correlation with PPD (r=0.72) and CAL (r=0.69), indicating that as glycemic levels worsened, periodontal destruction increased. Additionally, 18% of participants were found to have undiagnosed diabetes, emphasizing the potential role of periodontal health in diabetes screening.
Conclusion: Poor glycemic control is strongly associated with increased periodontitis severity. The high prevalence of undiagnosed diabetes among periodontitis patients underscores the need for routine glycemic screening in dental settings. Interdisciplinary collaboration between periodontists and physicians is essential for early detection and integrated management of diabetes and periodontal disease.
