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Undetected diabetes linked to myocardial infarction and periodontitis


People with undetected glucose disorders run a higher risk of both myocardial infarction and periodontitis, according to a study published in the journal Diabetes Care by researchers at Karolinska Institutet in Sweden.
The results have demonstrated the need of greater collaboration between dentistry and healthcare, and possibly of screening for diabetes at dental clinics.

Severe periodontitis is already known to be associated with a higher risk of myocardial infarction and lowered glucose tolerance, and diabetes to be more common in people who have suffered a myocardial infarction.

The researchers behind these earlier findings have now studied whether undetected glucose disorders ( dysglycaemia ), that is, a reduced ability to metabolise glucose, is linked to both these conditions: myocardial infarction and periodontitis.

The study was a collaboration between cardiologists and dentists at Karolinska Institutet and was based on data from a previous study called PAROKRANK.
It included 805 myocardial infarction patients from 17 Swedish cardiology clinics and 805 controls, who were matched by age, sex and post code.
The patients' periodontitic status was assessed with X-rays and dysglycaemic status with glucose load tests.

Participants with a diabetes diagnosis were excluded from the study, which left 712 patients and 731 controls with data on both periodontitic status and glucose status, the latter of which was divided into three categories: normal, reduced glucose tolerance, newly detected diabetes.
Comparisons were made after adjusting for age, sex, smoking habits, education and civil status.

The study has shown that previously undetected glucose disorders, which include diabetes and impaired glucose tolerance, were linked to myocardial infarction.
It was roughly twice as common for myocardial infarction patients to have undetected dysglycaemia as for healthy controls, confirming the research group's earlier findings.

Undetected diabetes was also found to be linked to severe periodontitis.
When myocardial infarction patients and controls were analysed separately, the association was clearer in the patients than in the controls, which is possibly because many of the controls were very healthy and few had severe periodontitis and undetected diabetes.

The findings have indicated that dysglycaemia is a key risk factor in both severe periodontitis and myocardial infarction and that the combination of severe periodontitis and undetected diabetes further increases the risk of myocardial infarction.

One of the study's limitations is that despite the large number of participants, the number of patients and controls with severe periodontitis and undetected diabetes was low.
The observed differences in the links between undetected diabetes and severe periodontitis in patients and controls can therefore be attributable either to the low number of patients or to genuine differences in correlation. ( Xagena )

Source: Karolinska Institutet, 2019

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