title: Association between periodontitis needing surgical treatment and subsequent diabetes risk: a population-based cohort study.
abstract: BACKGROUND
  It is well known that patients with diabetes have higher extent and severity of periodontitis, but the backward relationship is little investigated. The relationship between periodontitis needing dental surgery and subsequent type 2 diabetes mellitus (DMT2) in those individuals without diabetes was assessed.
  
  
  METHODS
  This is a retrospective cohort study using data from the national health insurance system of Taiwan. The periodontitis cohort involved 22,299 patients, excluding those with diabetes already or those diagnosed with diabetes within 1 year from baseline. Each study participant was randomly frequency matched by age, sex, and index year with one individual from the general population without periodontitis. Cox proportional hazards regression analysis was used to estimate the influence of periodontitis on the risk of diabetes.
  
  
  RESULTS
  The mean follow-up period is 5.47 ± 3.54 years. Overall, the subsequent incidence of DMT2 was 1.24-fold higher in the periodontitis cohort than in the control cohort, with an adjusted hazard ratio of 1.19 (95% confidence interval = 1.10 to 1.29) after controlling for sex, age, and comorbidities.
  
  
  CONCLUSIONS
  This is the largest nation-based study examining the risk of diabetes in Asian patients with periodontitis. Those patients with periodontitis needing dental surgery have increased risk of future diabetes within 2 years compared with those participants with periodontitis not requiring dental surgery.
authors.affiliation: Institute of Clinical Medical Science, China Medical University College of Medicine, Taichung, Taiwan.
authors.forename: Shih-Yi
authors.initials: SY
authors.lastname: Lin
authors.forename: Cheng-Li
authors.initials: CL
authors.lastname: Lin
authors.forename: Jiung-Hsiun
authors.initials: JH
authors.lastname: Liu
authors.forename: I-Kuan
authors.initials: IK
authors.lastname: Wang
authors.forename: Wu-Huei
authors.initials: WH
authors.lastname: Hsu
authors.forename: Chao-Jung
authors.initials: CJ
authors.lastname: Chen
authors.forename: I-Wen
authors.initials: IW
authors.lastname: Ting
authors.forename: I-Ting
authors.initials: IT
authors.lastname: Wu
authors.forename: Fung-Chang
authors.initials: FC
authors.lastname: Sung
authors.forename: Chiu-Ching
authors.initials: CC
authors.lastname: Huang
authors.forename: Yen-Jung
authors.initials: YJ
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D015331:Cohort Studies; D003324:Coronary Artery Disease / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006949:Hyperlipidemias / Q000453:epidemiology; D006973:Hypertension / Q000453:epidemiology; D015994:Incidence; D007182:Income / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D010518:Periodontitis / Q000453:epidemiology / Q000601:surgery*; D011159:Population Surveillance; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013357:Subgingival Curettage / Q000706:statistics & numerical data; D013524:Surgical Flaps / Q000706:statistics & numerical data; D013624:Taiwan / Q000453:epidemiology; D014504:Urban Health / Q000706:statistics & numerical data
keywords: Diabetes mellitus; periodontitis; retrospective studies; type 2