title: Pre-diabetes and well-controlled diabetes are not associated with periodontal disease: the SHIP Trend Study.
abstract: OBJECTIVE
  To examine associations of pre-diabetes and well-controlled diabetes with periodontitis.
  
  
  METHODS
  The Study of Health in Pomerania (SHIP)-Trend is a cross-sectional survey in North-Eastern Germany including 3086 participants (49.4% men; age 20-82 years). Clinical attachment loss (CAL) and periodontal probing depth (PPD) were assessed applying a random half-mouth protocol. The number of teeth was determined. Pre-diabetes comprised impaired fasting glucose and impaired glucose tolerance. Previously known diabetes was defined as well controlled if glycated haemoglobin (HbA1c) was <7.0%. Participants were categorized as follows: normal glucose tolerance (NGT), pre-diabetes, newly detected type 2 diabetes (T2DM), known T2DM with HbA1c<7.0% and known T2DM with HbA1c≥7.0%.
  
  
  RESULTS
  Pre-diabetes was neither associated with mean CAL and PPD in multivariable adjusted linear regression models nor with edentulism (OR = 1.09 (95%-CI: 0.69-1.71)) and number of teeth (OR = 0.96 (95%-CI: 0.75-1.22), lowest quartile versus higher quartiles) in logistic regression models. Associations with mean CAL and edentulism were stronger in poorly controlled previously known diabetes than in well-controlled previously known diabetes (for edentulism: OR = 2.19 (95%-CI: 1.18-4.05), and OR = 1.40 (95%-CI: 0.82-2.38), respectively, for comparison with NGT).
  
  
  CONCLUSIONS
  Periodontitis and edentulism were associated with poorly controlled T2DM, but not with pre-diabetes and well-controlled diabetes.
authors: German Diabetes Center, Institute of Biometrics and Epidemiology, Düsseldorf, Germany.|Center of Clinical Epidemiology, c/o Institute of Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital, Essen, Germany.
authors: Bernd
authors: B
authors: Kowall
authors: Unit of Periodontology, Department of Restorative Dentistry, Periodontology, and Endodontology, University Medicine, Ernst-Moritz-Arndt-University, Greifswald, Germany.
authors: Birte
authors: B
authors: Holtfreter
authors: Institute for Community Medicine, University Medicine, Ernst-Moritz-Arndt-University, Greifswald, Germany;
authors: Henry
authors: H
authors: Völzke
authors: Institute for Community Medicine, University Medicine, Ernst-Moritz-Arndt-University, Greifswald, Germany;
authors: Sabine
authors: S
authors: Schipf
authors: Department of Prosthodontics, Gerodontology and Biomaterials, Dental School, University Medicine, Ernst-Moritz-Arndt-University, Greifswald, Germany.
authors: Torsten
authors: T
authors: Mundt
authors: German Diabetes Center, Institute of Biometrics and Epidemiology, Düsseldorf, Germany.
authors: Wolfgang
authors: W
authors: Rathmann
authors: Unit of Periodontology, Department of Restorative Dentistry, Periodontology, and Endodontology, University Medicine, Ernst-Moritz-Arndt-University, Greifswald, Germany.
authors: Thomas
authors: T
authors: Kocher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D003924:Diabetes Mellitus, Type 2 / Q000453:epidemiology* / Q000517:prevention & control; D004522:Educational Status; D005260:Female; D005858:Germany / Q000453:epidemiology; D005951:Glucose Tolerance Test; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007576:Jaw, Edentulous, Partially / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009066:Mouth, Edentulous / Q000453:epidemiology; D017622:Periodontal Attachment Loss / Q000453:epidemiology; D010514:Periodontal Pocket / Q000453:epidemiology; D010518:Periodontitis / Q000453:epidemiology*; D011159:Population Surveillance; D011236:Prediabetic State / Q000453:epidemiology*; D012737:Sex Factors; D055815:Young Adult
chemical_list: D001786:Blood Glucose; D006442:Glycated Hemoglobin
keywords: diabetes mellitus; edentulous; glucose intolerance; hyperglycaemia; mouth; periodontal attachment loss; periodontal diseases; periodontitis; pre-diabetic state