Relationship between diabetes self-care practices and control of periodontal disease among type2 diabetes patients in Bangladesh

• Published in: PloS one 2021-04, Vol.16 (4), p.e0249011-e0249011
• Main Authors: Hasan, S M Mahmudul, Rahman, Mosiur, Nakamura, Keiko, Tashiro, Yuri, Miyashita, Ayano, Seino, Kaoruko
• Format: Article
• Language: English
• Subjects: Activities of daily living; Adult; Bangladesh; Biology and life sciences; Blood pressure; Care and treatment; Complications and side effects; Control; Data analysis; Data collection; Dental care; Dental hygiene; Dentistry; Dentists; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - epidemiology; Diabetes Mellitus, Type 2 - therapy; Disease; Disease control; Drafting software; Editing; Entrepreneurship; Epidemics; Female; Graduate schools; Graduate studies; Gum disease; Health care; Human resources; Humans; Hygiene; Male; Medicine and Health Sciences; Metabolic disorders; Methodology; Middle Aged; Morbidity; Mouth; Oral hygiene; Oral Hygiene - statistics & numerical data; Patients; Periodontal disease; Periodontal diseases; Periodontitis - epidemiology; Periodontitis - prevention & control; Physiological aspects; Prevalence; Prevention; Psychological aspects; Public health; Questionnaires; Resource development; Risk factors; Self Care - statistics & numerical data; Self-care, Health; Sociodemographics; Teeth; Type 2 diabetes
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0249011

The prevalence of periodontal disease is high in diabetes patients worldwide, including Bangladesh. Although associations of periodontal disease outcomes and clinical determinants of diabetes have been investigated, few studies have reported on the relationship between periodontal diseases outcomes with modifiable factors, such as self-care and oral hygiene practices, in patients with diabetes. Moreover, in order to develop targeted strategies, it is also important to estimate their aggregated contribution separately from that of the established sociodemographic and diabetics related clinical determinates. Therefore, this study was performed to elucidate 1) the relationship of diabetes patients' self-care and oral hygiene practices to periodontal disease and 2) the relative contributions of selected factors to periodontal disease outcome in type 2 diabetes patients. The data were obtained from the baseline survey of a multicentre, prospective cohort study. A total of 379 adult patients with type 2 diabetes from three diabetic centres in Dhaka, Rajshahi and Barishal, received periodontal examinations using the community periodontal index (CPI) probe, glycated haemoglobin examination, other clinical examinations, and structured questionnaires. Multiple logistics regression analyses were performed to assess the associations between selected factors and prevalence of any periodontal disease and its severity. More than half of the participants were female (53.8%) and 66.8% of the total participants was 21-50 years old. The prevalence of any (CPI code 2+3+4; 75.7%) and severe form (CPI code 4; 35.1%) of periodontal disease were high in type 2 diabetes patients. In multivariate analysis, the odds of periodontal disease increased with unfavourable glycaemic control indicated by HbA1c ≥ 7%, and decreased by 64%, 85% and 92% with adherence to recommended diet, physical activity, and oral hygiene practices, respectively. Diabetes self-care practice explained the highest proportion of the variance (13.9%) followed by oral hygiene practices (10.9%) by modelling any periodontal disease versus no disease. Variables of diabetes conditions and oral hygiene practices explained 10.9% and 7.3% of the variance by modelling severe (CPI code 4) or moderate (CPI code 3) forms of periodontal disease versus mild form of periodontal disease. Findings also conferred that while poor diabetes control had an individually adverse association with any form of periodontal diseases and its