Gum disease tied to diabetes risk

By Amy Norton

NEW YORK (Reuters Health) - People with moderate to severe gum disease may have an elevated risk of developing type 2 diabetes, the results of a new study suggests.

Researchers found that among nearly 9,300 U.S. adults who were followed for 17 years, those who began the study with gum disease were more likely to develop diabetes later on. Men and women with moderate gum disease had twice the risk of diabetes as those with healthy gums, while substantial tooth loss was linked to a 70 percent higher risk.

The findings, published in the journal Diabetes Care, do not prove that gum disease causes diabetes in some people. But the study is the first to show such a temporal association between the two conditions; the relationship between diabetes and gum disease is well-known, but it has traditionally been assumed that gum disease is solely a consequence of diabetes.

"The pertinent finding was our observation that periodontal disease can precede the onset of overt type 2 diabetes," lead researcher Dr. Ryan T. Demmer, of Columbia University in New York, told Reuters Health.

He added, however, that more studies are needed both to prove that gum disease directly contributes to type 2 diabetes, and, from there, that treating the dental problem can prevent diabetes.

"It would be inappropriate, based on our findings, to definitively say that better oral health will reduce an individual's risk of diabetes development," Demmer said.

Still, the findings are in line with research suggesting that gum disease is a risk factor for heart disease and stroke. Gum disease arises from bacterial infection, and it is thought that chronic, systemic inflammation in response to the bacteria may contribute to cardiovascular disease.

In theory, this could also explain the link to diabetes. Demmer noted that inflammatory molecules could, for instance, affect the body's sensitivity to the blood-sugar-regulating hormone insulin. For now, though, that is a theory.

SOURCE: Diabetes Care, July 2008.