ANN ARBOR ?

ANAHEIM, Calif.?

Two common, chronic conditions—diabetes and periodontal (gum) disease—have a complex connection that goes in both directions. People with diabetes are at increased risk of getting periodontal disease. And periodontal disease, in turn, may make diabetes worse. It leads to problems with the control of blood sugar levels, which can increase the risk of complications such as vision problems, nerve damage, kidney disease and cardiovascular disease.

George W. Taylor, University of Michigan assistant professor of dentistry, discussed these and other connections between diabetes and oral health at the annual meeting of the American Association for the Advancement of Science. Taylor spoke during a symposium titled “The Link Between Systemic Conditions and Diseases and Oral Health.”

Evidence about the relationship between diabetes and periodontal disease comes from both epidemiological and clinical studies, said Taylor. For example, he has analyzed data from a long-term study of Pima Indians, who have a high prevalence of both diabetes and periodontal disease. The results showed that people with Type II (adult onset) diabetes are about three times more likely than non-diabetics to get periodontal disease. The disease also is more likely to progress rapidly and to more severe stages in people with diabetes, said Taylor.

To look at the effect of periodontal disease on diabetes, Taylor compared glycemic (blood sugar) control in two groups of people with diabetes. The first group had mild periodontal disease or none at all. The second group had more severe periodontal disease.

“The fascinating finding was that people with more severe periodontal disease were six times more likely to have poor glycemic control at follow-up than those who had less severe periodontal disease,” said Taylor.

Clinical studies also hint at the same connections. Researchers at the State University of New York, Buffalo, treated a group of Pima Indians for periodontal disease and measured their glycemic control three months later. They found improved glycemic control along with a reduction in the bacteria that cause periodontal disease, said Taylor.

Other research under way at several universities, he added, is aimed at uncovering the biological basis of the relationship between periodontal disease and diabetes and at examining the links between diabetes and other oral health problems, such as tooth decay, tooth loss and reduced salivary flow.