Oral infections and glycemic control in pregnant type 2 diabetics.
BACKGROUND
The relationship between diabetes mellitus and infection is bidirectional. Diabetes favors infection, while infections make controlling diabetes much more difficult. The most frequent infections encountered in pregnant diabetics are those of the urinary tract (UTI) and cervicovaginal (CVI) area. Periodontal diseases (PD) and active caries (AC) are infectious diseases frequently found in these cases often remaining as hidden entities of low intensity. The aim of this study was to assess whether there is an association between PD and caries with lack of glycemic control often encountered in pregnant type 2 diabetic women.


METHODS
A single skilled researcher performed the periodontal evaluation of PD and AC cases. Glycated alpha hemoglobin (HbA(1c)) over 6.5% was used to diagnose metabolic glucose disturbances. The controlled variables were UTI, CVI and adherence to treatment. The statistical tests used were chi-square adjusted for continuity, analysis of variance, odds ratio with 95% confidence intervals and logistic regression with a significance level of p < 0.05.


RESULTS
One hundred twenty-seven type 2 diabetic women were seen during the second trimester of their pregnancies. Mean age was 31.3 years; 55% had lack of glycemic control associated with CVI (chi2 21.07, p < 0.000), PD (chi2 5.72, p < 0.005) and UTI (chi2 13.77, p < 0.000) with therapeutic adherence (TA) (chi2 14.80, p < 0.00). No association was found with AC. The logistic regression results showed that UTI, CIV, PD and TA are associated with lack of glycemic control.


CONCLUSIONS
Periodontal diseases may act as "hidden" infections in pregnant diabetics and be associated with lack of glycemic control. This situation should be taken into consideration by healthcare teams in charge of prenatal care.
Díaz-Romero
Rosa María
RM
Instituto Nacional de Perinatología, Mexico, D.F., Mexico. fvadiaz@prodigy.net.mx
Casanova-Román
Gerardo
G
Beltrán-Zuñiga
Magdalena
M
Belmont-Padilla
Juan
J
Méndez
José D
JD
Avila-Rosas
Héctor
H
D000328:Adult; D001786:Blood Glucose / Q000378:metabolism*; D003731:Dental Caries / Q000378:metabolism*; D048909:Diabetes Complications / Q000378:metabolism*; D003924:Diabetes Mellitus, Type 2 / Q000378:metabolism*; D005260:Female; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D008297:Male; D009059:Mouth Diseases / Q000175:diagnosis / Q000378:metabolism*; D011247:Pregnancy / Q000378:metabolism*; D011262:Pregnancy Trimester, Second; D012044:Regression Analysis; D014552:Urinary Tract Infections / Q000378:metabolism
D001786:Blood Glucose; D006442:Glycated Hemoglobin