Diabetic patients with more severe periodontal disease are at increased risk for neuropathic foot ulceration, say researchers.

“Diabetic neuropathy (DN) has been associated with oral dryness, tooth loss and an increased risk for foot ulceration, but the association between periodontal problems and DN has not been fully elucidated,” explain Helena Schmid (Universidade Federal de Ciências da Saúde de Porto Alegre, Brazil) and team.

Writing in the journal Diabetes Research and Clinical Practice, the authors report that of 122 patients with Type 2 diabetes, none/mild and moderate/severe periodontal disease was observed in 40.2% and 32.0% individuals, respectively, and a further 27.8% of the group were edentulous.

The patients had a mean age of 60.5 years, duration of diabetes of 14.5 years, and glycated hemoglobin of 9.3%.

Degree of severity of periodontal disease correlated significantly with presence of neuropathic foot ulceration. Overall, 18.4%, 68.2%, and 61.8% of the participants who had none/mild or moderate/severe periodontal disease, or who were completely edentulous, respectively, had neuropathic foot ulceration.

Following adjustment for gender, age, diabetes duration, dental healthcare, and education, the researchers found that moderate/severe periodontal disease and edentulism increased the risk for neuropathic foot ulceration 6.6 and 4.9 fold, respectively, compared with none/mild periodontal disease.

Schmid and colleagues caution that “it is still unclear whether severe neuropathy or other simultaneous complications increase the chances of periodontal disease.”

They suggest: “Future prospective studies should be conducted to evaluate potential mechanisms of diabetic complications, such as systemic and inflammatory factors, neuropathy measurements, occurrence of ulcers and diabetes-associated periodontitis.”

MedWire (www.medwire-news.md) is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

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