Periodontal disease in non-insulin-dependent diabetes mellitus (NIDDM). The effect of age and time since diagnosis
The aim of this study was to determine the influence of the patient's age and the time of evolution of diabetes on periodontal disease. A total of 100 NIDDM patients were used in the study. The groups were defined as follows: Group 1 (G1), patients more than 55 years of age and diabetes diagnosed more than five years ago; Group 2 (G2), patients less than 55 years of age and diabetes diagnosed more than five years ago; Group 3 (G3), patients more than 55 years of age and diabetes diagnosed less than five years ago; and Group 4 (G4), patients less than 55 years of age and diabetes diagnosed less than five years ago.
Periodontal condition was assessed in a total of six teeth. Buccal (B) and lingual (L) pockets were measured, three points B and three points L recession (B and L); attachment loss (AL), bleeding on probing (BOP), alveolar bone loss (ABL), and tooth mobility (M). Metabolic control was evaluated by fasting blood glucose-oxidase method. Both B and L pockets were deeper for G1 and G2. There was no difference between age groups with the same years since the diabetes was diagnosed. The B and L recessions were also greater in G1 and G2. When comparing G3 and G4, greater recession was found in older patients. The AL was significantly increased for G1 and G2. For groups with a diagnosis of diabetes less than five years ago there was greater AL in G3. Patients with less than five years of diabetes and who were 55 years of age or younger had lower indices of gingival bleeding. There was a statistical difference among all groups regarding bone loss. There were high indices for older groups (1 and 2) and also for patients who were diagnosed five or more years ago. Blood glucose levels and tooth mobility were similar in all groups. The depth of B and L pockets increases with increasing years with diabetes diagnosis, but is not associated with age. The number of years since diabetes diagnosis also was important in recession; age also was important here. AL was the most important factor, depending mostly on time of diagnosis of diabetes. There was a correlation between bone loss and age.
In conclusion, for patients with NIDDM, the time since diagnosis of the disease was the most significant factor associated with periodontal disease. The age of the patient was associated with AL and recession only in those patients with a diagnosis of more than five years. [c.c.]
Cerda, J.G., C.Vasquez de la Torre, J.M. Malacara, and L.E. Nava, J Periodont, 65:991,1994