Gum Disease Raises Death Risk
in Diabetics
Severe gum disease may hasten death in
people with diabetes, new study findings suggest.
Study author Dr. William C. Knowler, stated that
"Diabetic people with periodontal disease
had increased death rates due to cardiovascular
disease and renal (kidney) failure, which are
two major complications of type 2 diabetes."
Knowler said, the findings underscore the need
for good oral hygiene in diabetics, who are particularly
prone to periodontitis, or gum disease.
Gum disease, characterized by red, swollen gums,
is caused by a bacterial infection. And studies
have indicated that infections and inflammation
can promote blood-vessel damage in the heart and
kidneys, said Knowler, chief of the diabetes and
arthritis epidemiology section of the National
Institute of Diabetes and Digestive and Kidney
Diseases in Phoenix.
While gum disease might not be diagnosed until
mid-life or later, infection with the bacteria
that cause it can occur decades earlier. Combined
with years of inadequate oral hygiene, infection
can result in gingivitis, an early form of gum
disease characterized by inflamed gums that often
bleed easily. This form of the disease can usually
be reversed with more careful brushing and flossing.
But as the more aggressive periodontitis develops,
the gums and bone surrounding the teeth can become
seriously damaged, and teeth may loosen or fall
out.
The new study involved 549 Pima Indians ages 45
or older with type 2 diabetes, the most common
form of the disease. At the beginning of the study,
the prevalence of severe gum disease, marked by
the loss of bone and often teeth, was roughly
60 percent.
During a follow-up period of about 10 years, 172
participants died of natural causes, according
to findings presented at ADA.
Overall, the rate of death from natural causes
was 42 per 1,000 people per year among participants
with severe gum disease, compared with 26.6 per
1,000 people per year among those who did not.
The extra deaths among those with severe gum disease
were due to heart disease and diabetic nephropathy,
and not to other causes such as cancer or liver
disease, Knowler and colleagues concluded.
Diabetic nephropathy is a condition in which diabetes
damages the kidneys, which then progressively
lose their ability to function normally and eventually
fail.
After adjusting for factors such as age, sex,
duration of diabetes, obesity and cholesterol
levels, the researchers found that diabetics with
severe gum disease were twice as likely as those
without it to die from either heart disease or
kidney failure.
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and 15% in 2000.
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