Eur J Med Res：糖尿病患者需要口腔健康教育

一项在线发表于《欧洲医学研究》的研究表明，2型糖尿病与牙周炎可相互影响，糖尿病患者迫切需要接受口腔健康相关教育。
“牙科医生和糖尿病医生应及时告知糖尿病患者，他们罹患牙周炎的风险性在增加。”研究主要负责人、德国汉诺威医学院学者Knut Weinspach指出。
Weinspach领导的研究团队对448例参与全德糖尿病信息计划的患者展开调查，患者平均年龄59.65岁，其中224例为女性，101例患有1型糖尿病，236患2型糖尿病。研究者对其进行口腔检查，并就糖尿病与牙周炎相关性的背景知识对其进行调查。
研究结果提示，牙齿健康的标志---龋齿、牙齿缺损和经充填牙齿的数量在1型糖尿病患者中最低，在2型糖尿病患者中最高，而健康人群则介于两者之间，分别达到16.12颗、18.8颗和17.81颗。以牙齿健康的另一标志——牙周筛查指数衡量结果亦相同：1型糖尿病患者中分数最低，2型糖尿病患者最高。
作者指出，1型糖尿病患者牙周炎总体发生率约为65%，健康人群为85%，2型糖尿病患者中则达到90%。值得注意的是，牙周炎的发生率与糖尿病病情控制程度（以糖化血红蛋白水平为标志）无关。然而多因素分析发现，患者高龄、男性、高体质指数可作为糖尿病患者并发牙周疾病的显著独立预测因子。
当被问及“你是否了解牙周炎与糖尿病的相互影响”时，1型糖尿病患者回答“是”的比例最高。整体而言仍有55%的受试者未意识到两者之间的相关性。
与糖尿病相关的拓展阅读：

• 糖尿病患者需要口腔健康教育
• Diabetes Care：青少年期肥胖增高糖尿病风险
• Diabetes Care：糖尿病与心衰患者心脏交感神经活性降低相关
• Diabetes Care：lixisenatide有效改善二甲双胍控制不佳的2型糖尿病人群的血糖
• 2013 NIH 妊娠期糖尿病(GDM)诊断声明
• JAMA：褪黑激素分泌减少增加II型糖尿病风险
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Level of information about the relationship between diabetes mellitus and periodontitis - results from a nationwide diabetes information program
Background
A comprehensive knowledge about the mutual influence between diabetes and periodontitis is decisive for the successful treatment of both diseases. The present investigation aimed at assessing the diabetic and periodontal conditions and, in particular, the degree of knowledge about the relationship between diabetes and periodontitis.
Methods
During a diabetes information program, 111 nondiabetics (ND), 101 type 1 diabetics (T1D), and 236 type 2 diabetics (T2D) were subject to a medical and dental examination and completed a self-administered questionnaire. Medical examination included measurements of glycated hemoglobin (HbA1c), blood glucose (BG), and body mass index (BMI). Full-mouth examination consisted of the assessment of the decayed, missing, filled teeth index (DMFT) and the periodontal screening index (PSI). Chi-square test, ANOVA, t test of independent samples, univariate and multivariate logistic regression models with variable selection strategies were used for statistical analyses. Due to the exploratory character of the investigation a value of P ≤0.05 was considered to be statistically substantial.
Results
T2D had a significantly higher PSI when compared to T1D and ND (t test: P <0.001; P = 0.005). Approximately 90% of T2D suffered from periodontitis. In addition, diabetics with periodontitis showed a significantly higher BMI when compared to diabetics without periodontitis (multivariate logistic regression: P = 0.002). Almost 60% of all investigated subjects were not informed about the mutual influence between diabetes and periodontitis. T2D had almost as little information about the increased risk for periodontitis as ND.
Conclusions
The data of the present investigation suggest that there is a strong association between type 2 diabetes and chronic periodontitis. The lack of awareness of the mutual influence between diabetes and periodontitis, especially in T2D, demonstrates that this topic is still neglected in dental and diabetic treatment.