Periodontal Disease May be Associated With the Occurrence of Diabetic
                    Retinopathy: A Subgroup Analysis of The Survey of the Diabetes Coordination
                    Notebook in Gifu

Yukio Horikawa; Akio Suzuki; Mayumi Enya; Ken-ichi Hashimoto; Shohei Nishida; Ryo Kobayashi; Tetsuya Ohashi; Futoshi Yamazaki; Rieko Totani; Hiroshi Kobayashi; Mayumi Yamamoto; Yoshinori Itoh; Jun Takeda

doi:10.1055/a-0879-1890

Experimental and Clinical Endocrinology & Diabetes, Inhaltsverzeichnis

Exp Clin Endocrinol Diabetes 2020; 128(04): 231-238
DOI: 10.1055/a-0879-1890

Article

Periodontal Disease May be Associated With the Occurrence of Diabetic Retinopathy: A Subgroup Analysis of The Survey of the Diabetes Coordination Notebook in Gifu

Autoren

Yukio Horikawa

¹Department of Diabetes and Endocrinology, Gifu University Graduate School of Medicine, Gifu, Japan
Akio Suzuki

²Department of Pharmacy, Gifu University Hospital, Gifu, Japan
Mayumi Enya

¹Department of Diabetes and Endocrinology, Gifu University Graduate School of Medicine, Gifu, Japan
Ken-ichi Hashimoto

¹Department of Diabetes and Endocrinology, Gifu University Graduate School of Medicine, Gifu, Japan
Shohei Nishida

²Department of Pharmacy, Gifu University Hospital, Gifu, Japan
Ryo Kobayashi

²Department of Pharmacy, Gifu University Hospital, Gifu, Japan
Tetsuya Ohashi

³Gifu Pharmaceutical Association, Gifu, Japan
Futoshi Yamazaki

³Gifu Pharmaceutical Association, Gifu, Japan
Rieko Totani

⁴Gifu Prefecture Medical Association, Gifu, Japan
Hiroshi Kobayashi

⁴Gifu Prefecture Medical Association, Gifu, Japan
Mayumi Yamamoto

⁵Health Administration Center, Gifu University, Gifu, Japan
Yoshinori Itoh

²Department of Pharmacy, Gifu University Hospital, Gifu, Japan
Jun Takeda

¹Department of Diabetes and Endocrinology, Gifu University Graduate School of Medicine, Gifu, Japan

Abstract

Aims A questionnaire survey of the prevalence of diabetic retinopathy was recently conducted in Japan. A subgroup analysis to examine the association of periodontal disease with diabetic retinopathy in subjects with diabetes and prediabetes was conducted.

Methods The association of the presence of periodontal disease with the occurrence of diabetic retinopathy was examined using multivariate logistic regression analysis.

Results Of 27 016 subjects who completed a survey at 217 community pharmacies, 5 572 had diabetes or prediabetes, among whom 522 and 1 421 had retinopathy or periodontal disease, respectively. Therapy duration≥10 years (OR: 2.73, 95% CI: 2.17–3.43, P<0.001), periodontal disease (OR: 2.10, 95% CI: 1.68–2.62, P<0.001) and glycated hemoglobin (HbA1c) ≥ 7.0% (OR: 1.64, 95% CI: 1.32–2.04, P<0.001) were significantly associated with the occurrence of retinopathy, while retinopathy (OR: 2.11, 95% CI: 1.69–2.63, P<0.001) and therapy duration ≥10 years (OR: 1.24, 95% CI: 1.06–1.46, P=0.007) were significantly associated with the occurrence of periodontal disease. The prevalence of retinopathy was much higher in diabetic subjects with periodontal disease than in those without it (15.1% vs. 7.8%, P<0.001). Notably, the difference of prevalence of retinopathy between subjects with and without periodontal disease was statistically significant even at HbA1c 6.0–6.9% (15.2% vs. 7.3%, P<0.01).

Conclusions These findings indicate that the target HbA1c level for diabetes patients with periodontal disease may be set lower than for those without it, and that regular dental visits should be prescribed for the management of periodontal disease and the prevention of diabetic retinopathy.

Key words

diabetic retinopathy - periodontal disease - glycated hemoglobin A

Volltext

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References
1 World Health Organization. Global report on diabetes. Geneva: World Health Organization; 2016
2 Yau JW, Rogers SL, Kawasaki R. et al. Meta-Analysis for Eye Disease (META-EYE) Study Group. Global prevalence and major risk factors of diabetic retinopathy. Diabetes Care 2012; 35: 556-564
3 Wong TY, Cheung CM, Larsen M. et al. Diabetic retinopathy. Nat Rev Dis Primers 2016; 2: 16012
4 Lee R, Wong TY, Sabanayagam C. Epidemiology of diabetic retinopathy, diabetic macular edema and related vision loss. Eye Vis (Lond) 2015; 2: 17
5 Nazir MA. Prevalence of periodontal disease, its association with systemic diseases and prevention. Int J Health Sci (Qassim) 2017; 11: 72-80
6 Eke PI, Wei L, Thornton-Evans GO. et al. Risk indicators for periodontitis in US Adults: NHANES 2009 to 2012. J Periodontol 2016; 87: 1174-1185
7 Preshaw PM, Alba AL, Herrera D. et al. Periodontitis and diabetes: A two-way relationship. Diabetologia 2012; 55: 21-31
8 Pucher J, Stewart J. Periodontal disease and diabetes mellitus. Curr Diab Rep 2004; 4: 46-50
9 Lakschevitz F, Aboodi G, Tenenbaum H. et al. Diabetes and periodontal diseases: Interplay and links. Curr Diabetes Rev 2011; 7: 433-439
10 Soskolne WA, Klinger A. The relationship between periodontal diseases and diabetes: An overview. J Diabetes Res 2002; 6: 91-98
11 Tsai C, Hayes C, Taylor GW. Glycemic control of type 2 diabetes and severe periodontal disease in the US adult population. Community Dent Oral Epidemiol 2002; 30: 182-192
12 Nelson RG, Shlossman M, Budding LM. et al. Periodontal disease and NIDDM in Pima Indians. Diabetes Care 1990; 13: 836-840
13 Malik G, Leh G, Manjit T. Association of periodontitis with diabetes mellitus: a review. J Med Coll Chandigar 2011; 1: 10-14
14 Salvi GE, Carollo-Bittel B, Lang NP. Effects of diabetes mellitus on periodontal and peri-implant conditions: update on associations and risks. J Clin Periodontol 2008; 35 (8 Suppl) 398-409
15 Rosenthal IM, Abrams H, Kopczyk A. The relationship of inflammatory periodontal disease to diabetic status in insulin-dependent diabetes mellitus patients. J Clin Periodontol 1988; 15: 425-429
16 Noma H, Sakamoto I, Mochizuki H. et al. Relationship between periodontal disease and diabetic retinopathy. Diabetes Care 2004; 27: 615
17 Song SJ, Lee SS, Han K. et al. Periodontitis is associated with diabetic retinopathy in non-obese adults. Endocrine 2017; 56: 82-89
18 Horikawa Y, Suzuki A, Hashimoto K. et al. Evaluation of the diabetes regional coordination path using the diabetes coordination notebook in community-based diabetes care. Diabetol Int
19 Japan Association for Diabetes Education and Care. https://www.nittokyo.or.jp/ Accessed 01/25/19.
20 Liu Y, Yang J, Tao L. et al. Risk factors of diabetic retinopathy and sight-threatening diabetic retinopathy: A cross-sectional study of 13 473 patients with type 2 diabetes mellitus in mainland China. BMJ Open. 2017; 7: e016280
21 Keen H, Lee ET, Russell D. et al. The appearance of retinopathy and progression to proliferative retinopathy: The WHO Multinational Study of Vascular Disease in Diabetes. Diabetologia. 2001; 44 (Suppl. 02) S22-S30
22 Looker HC, Krakoff J, Knowler WC. et al. Longitudinal studies of incidence and progression of diabetic retinopathy assessed by retinal photography in pima indians. Diabetes Care. 2003; 26: 320-326
23 Kajiwara A, Miyagawa H, Saruwatari J. et al. Gender differences in the incidence and progression of diabetic retinopathy among Japanese patients with type 2 diabetes mellitus: A clinic-based retrospective longitudinal study. Diabetes Res Clin Pract 2014; 103: e7-e10
24 Khanuja PK, Narula SC, Rajput R. et al. Association of periodontal disease with glycemic control in patients with type 2 diabetes in Indian population. Front Med. 2017; 11: 110-119
25 Khanuja PK, Narula SC, Rajput R. et al. Association of periodontal disease with glycemic control in patients with type 2 diabetes in Indian population. Front Med. 2017; 11: 110-119
26 Garcia D, Tarima S, Okunseri C. Periodontitis and glycemic control in diabetes: NHANES 2009 to 2012. J Periodontol 2015; 86: 499-506
27 Hong M, Kim HY, Seok H. et al. Prevalence and risk factors of periodontitis among adults with or without diabetes mellitus. Korean J Intern Med 2016; 31: 910-919
28 Ohkubo Y, Kishikawa H, Araki E. et al. Intensive insulin therapy prevents the progression of diabetic microvascular complications in Japanese patients with non-insulin-dependent diabetes mellitus: A randomized prospective 6-year study. Diabetes Res Clin Pract 1995; 28: 103-117
29 Diabetes Control and Complications Trial Research Group. Nathan DM, Genuth S, Lachin J. et al. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 1993; 329: 977-986
30 UK Prospective Diabetes Study (UKPDS) Group. Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 1998; 352: 837-853
31 Holman RR, Paul SK, Bethel MA. et al. 10-year follow-up of intensive glucose control in type 2 diabetes. N Engl J Med 2008; 359: 1577-1589
32 The Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications Research Group. Retinopathy and nephropathy in patients with type 1 diabetes four years after a trial of intensive therapy. N Engl J Med 2000; 342: 381-389
33 Saito T, Shimazaki Y, Kiyohara Y. et al. The severity of periodontal disease is associated with the development of glucose intolerance in non-diabetics: the Hisayama study. J Dent Res 2004; 83: 485-490
34 Eshaq RS, Aldalati AMZ, Alexander JS. et al. Diabetic retinopathy: Breaking the barrier. Pathophysiology 2017; 24: 229-241
35 Iwamoto Y, Nishimura F, Nakagawa M. et al. The effect of antimicrobial periodontal treatment on circulating tumor necrosis factor-alpha and glycated hemoglobin level in patients with type 2 diabetes. J Periodontol 2001; 72: 774-778
36 Al Habashneh R, Khader Y, Hammad MM. et al. Knowledge and awareness about diabetes and periodontal health among Jordanians. J Diabetes Complications 2010; 24: 409-414