ORAL PATHOLOGY
GINGIVAL INFLAMMATION AS A SIGN OF DIABETIC SYSTEMIC CHRONIC COMPLICATIONS
Radmila R Obradović 1a *, Aleksandar D Mitić 2b, Ljiljana G Kesić 1c, Ana S Pejčić 1d, Kosta M Todorović 3e, Milica S Petrović 1f
1
Department of Periodontology and Oral Medicine, Faculty of Medicine, Niš University, Serbia
2
Department of Dental Pathology and Endodontic, Faculty of Medicine, Niš University, Serbia
3
Department of Oral Surgery, Faculty of Medicine, Niš University, Serbia a
DDS, PhD, Assistant Professor b
DDS, PhD, Professor c
DDS, PhD, Professor d
DDS, PhD, Assistant Professor e
DDS, Assistant f
DDS, Postdoctoral Student
Received: April 14, 2016 Accepted: April 25, 2016
Available online: May 05, 2016
Cite this article: Obradović RR, Mitić AD, Kesić LG, Petrović AS, Pejčić AS, Petrović MS. Gingival inflammation as a sign of diabetic systemic chronic complications. Stoma Edu J. 2016; 3( 2): 200-204.
ABSTRACT
Introduction: Diabetes mellitus( DM) is a chronic metabolic disorder and the high level of blood glucose has profound effects on various systems of the human body. DM increases the risk of periodontal disease and the severe periodontal disease often coexists in diabetic patients with poor glycemic control. The aim of the study was to analyse periodontal health in patients with diabetes mellitus type 2 related to diabetic complications and glycohemoglobin A1c values. Methodology: One hundred patients with periodontitis and type 2 DM participated in the study. According to the glycohemoglobin A1c value they were divided in 4 groups: group 1( 4 %-6 % normal), group 2( 6.1 %-7 % good), group 3( 7.1 %-8 % moderately poor), group 4(> 8 % poor metabolic control). The presence of chronic systemic microvascular diabetic complications( retinopathy, nephropathy and neuropathy) was recorded and periodontal assessments( Plaque, Gingival, Calculus and Periodontal Disease Index) performed. The results were statistically analysed using MS Office Excel, program SPSS, 15.0 version. Results: Gingival index values depended on the level of HbA1c values and higher values of the Gingival and Periodontal Disease Index were noticed as the value of glycohemoglobin A1c was rising( p < 0,001). Gingival index values were higher in diabetics with diabetic chronic microvascular complications( p < 0.001). Conclusion: It is observed that pronounced gingival inflammation in diabetics is associated with systemic diabetic complications and poor glycemic control. Keywords: diabetes mellitus, glycohemoglobin A1c, diabetic complications, gingival inflammation, periodontitis.
1. Introduction Diabetes mellitus( DM) is a chronic metabolic disorder caused by the ineffectiveness of the insulin produced or by deficiency in production of insulin by the pancreas. Among diabetic patients over 45 years old, more than 95 % patients have type 2 DM 1. The high level of glucose present in the blood has profound effects on various systems of the human body 1. The determination of glycohemoglobin A1c( HbA1c) levels provides an estimate of the average blood glucose level over the preceding one to three months. The higher average blood glucose levels reflect in higher HbA1c values 2. HbA1c level is of major clinical values in assessment diabetes prognosis and correlates well with the development of diabetic complications. The recommended HbA1c target value for people with diabetes mellitus is < 7.0 % and achieving this goal is very difficult 3. DM significantly increases the prevalence, severity, and rate of progression of periodontal disease, and periodontal disease is
* Corresponding author:
Assistant Professor Radmila Obradović, DDS, PhD Faculty of Medicine, University of Niš 81, Dr Zoran Đinđić Blvd, 18000 Niš, SERBIA Tel: + 381-64-235-9595; Fax: + 381-18-42-38-770, e-mail: dr. rada @ yahoo. com
200 STOMA. EDUJ( 2016) 3( 2)