People with undetected glucose disorders run a higher risk of both heart attack and gum disease, according to researchers at Karolinska Institutet in Sweden.
The results demonstrate the need of greater collaboration between dentistry and healthcare, say the researchers, and possibly of screening for diabetes at dental clinics.
Severe gum disease or periodontitis is already known to be associated with a higher risk of myocardial infarction and lowered glucose tolerance, and diabetes tends to be more common in people who have suffered a heart attack.
The researchers behind these earlier findings have now studied whether undetected glucose disorders (dysglycaemia) – that is, a reduced ability to metabolize sugar – is linked to both these conditions: myocardial infarction and periodontitis.
How was the Study Conducted?
The study was a collaboration between cardiologists and dentists at Karolinska Institutet and was based on data from a previous study called PAROKRANK.
It included 805 myocardial infarction patients from 17 Swedish cardiology clinics and 805 controls, who were matched by age, sex and area. The patients’ periodontitic status was assessed with X-rays and dysglycemic status with glucose load tests.
Participants with a diabetes diagnosis were excluded from the study, which left 712 patients and 731 controls with data on both periodontitic status and glucose status, the latter of which was divided into three categories: normal, reduced glucose tolerance, newly detected diabetes.
Comparisons were made after adjusting for age, sex, smoking habits, education, and civil status.
What were the Findings?
The study shows that previously undetected glucose disorders, which include diabetes and impaired glucose tolerance, were linked to myocardial infarction.
It was roughly twice as common for myocardial infarction patients to have undetected dysglycaemia as for healthy controls, confirming the research group’s earlier findings. Myocardial infarction affects approximately 30,000 people in Sweden annually.
Undetected diabetes was also found to be linked to severe periodontitis.
When myocardial infarction patients and controls were analyzed separately, the association was clearer in the patients than in the controls, which is possible because many of the controls were very healthy and few had severe periodontitis and undetected diabetes.
“Our findings indicate that dysglycaemia is a key risk factor in both severe periodontitis and myocardial infarction and that the combination of severe periodontitis and undetected diabetes further increases the risk of myocardial infarction,” says the study’s lead author Dr. Anna Norhammar, cardiologist and associate professor at Karolinska Institutet’s Department of Medicine in Solna.
The results substantiate previously known links between periodontitis and diabetes and show that such an association also exists in previously unknown diabetes.
According to the researchers, the findings should make diabetes specialists consider their patients’ dental health and the need for closer collaboration with dentists.
“The PAROKRANK study is a good example of such collaboration,” says the present study’s senior author Dr. Lars Rydén, professor at Karolinska Institutet’s Department of Medicine in Solna and chair of the academically initiated PAROKRANK study.
“Our study shows that undetected glucose disorders are common in two major diseases – myocardial infarction and periodontitis,” says Norhammar. “Many people visit the dentist regularly and maybe it’s worth considering taking routine blood-sugar tests in patients with severe periodontitis to catch these patients.”
One of the study’s limitations is that despite a large number of participants, the number of patients and controls with severe periodontitis and undetected diabetes was low.
The observed differences in the links between undetected diabetes and severe periodontitis in patients and controls can, therefore, be attributable either to the low number of patients or to genuine differences in correlation.
The study published in the journal Diabetes Care.
The study was financed with grants from AFA Insurance, the Swedish Heart and Lung Foundation, the Swedish Research Council and Region Stockholm (ALF funding).
- Karolinska Institutet. (2019, June 10). Undetected diabetes linked to heart attack and gum disease. (2019, June 10). EurekAlert! Retrieved, June 12, 2019, from https://www.eurekalert.org/pub_releases/2019-06/ki-udl060519.php