Periodontitis and type 2 diabetes mellitus are known to have an association but until now the relationship between periodontal microbiota common in periodontitis and early diabetes risk had not been investigated. In the first study of its kind, researchers at Columbia University’s Mailman School of Public Health demonstrated an association between levels of periodontal microbiota and prediabetes prevalence among young diabetes-free adults. Findings are online in the Journal of Dental Research.
Prediabetes is defined according to the following criteria developed by the American Diabetes Association: i) hemoglobin A1c values ranging from 5.7 percent to 6.4 percent; ii) or a fasting blood glucose level ranging from 100 to 125 mg/dL.
The researchers studied the relationship between levels of 11 periodontal bacteria and prediabetes prevalence among 300 diabetes-free men and women members of the Service Employees International Union 1199, aged 20 to 55, who were enrolled from February 2011 to May 2013 in the Oral Infections, Glucose Intolerance, and Insulin Resistance Study (ORIGINS). In addition to meeting the criteria for A1C and fasting blood glucose levels and therefore, having no history of diabetes mellitus, participants also self-reported no myocardial infarction, congestive heart failure, stroke, or chronic inflammatory conditions.
Type 2 diabetes (T2D) causes 450,000 deaths a year and represents 19 percent of all deaths among individuals older than age 25. Impaired glucose regulation before onset of Type 2 diabetes is a growing public health concern, affecting 38 percent of U.S. adults and a strong predictor of future overt Type 2 diabetes and cardiovascular disease.
Study participants were an average 34 years old, 77 percent female, and 47 percent Hispanic, 23 percent white, and 17 percent black. Nearly 70 percent of participants had a college degree, and only 4 percent had less than a high school education; 90 percent of participants were nonsmokers, and ~80 percent were never smokers.
“Our data advance current knowledge about the relationship between Type 2 diabetes and periodontitis by demonstrating the emerging associations between periodontal bacteria and glucose levels preceding diabetes development and overt hyperglycemia,” said Dr. Ryan Demmer, assistant professor of Epidemiology. “This observation supports the hypothesis that periodontal bacteria might contribute to the early stages of diabetes development rather than simply reflecting hyperglycemia in diabetes. The public health implications could be significant given the high population prevalence of periodontal infections in the U.S.”
The research was supported by the National Institutes of Health (R00 DE018739, R21 DE022422). Grant R01 DK102932 recently has been awarded to Dr. Demmer to expand the research. Dr. Demmer also received funding from a Calderone Research Award, Mailman School of Public Health, and a Pilot & Feasibility Award from the Diabetes and Endocrinology Research Center, College of Physicians and Surgeons (DK-63608). This publication was also supported by the National Center for Advancing Translational Sciences, National Institutes of Health (grant UL1 TR000040), formerly the National Center for Research Resources (grant UL1 RR024156).