Oral Infections and Glycemic Control in Pregnant Type 2 Diabetics

• Published in: Archives of medical research Vol. 36; no. 1; pp. 42 - 48
• Main Authors: Díaz-Romero, Rosa María, Casanova-Román, Gerardo, Beltrán-Zuñiga, Magdalena, Belmont-Padilla, Juan, Méndez, José D., Ávila-Rosas, Héctor
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 2005
• Subjects: Adult; Blood Glucose - metabolism; Dental Caries - metabolism; Diabetes Complications - metabolism; Diabetes mellitus; Diabetes Mellitus, Type 2 - metabolism; Female; Glycated Hemoglobin A - metabolism; Humans; Male; Mouth Diseases - diagnosis; Mouth Diseases - metabolism; Periodontal diseases; Pregnancy; Pregnancy - metabolism; Pregnancy Trimester, Second; Regression Analysis; Urinary Tract Infections - metabolism; Periodontal diseases; Pregnancy; Diabetes mellitus
• DOI: 10.1016/j.arcmed.2005.01.002
• ISSN: 0188-4409

The relationship between diabetes mellitus and infection is bidirectional. Diabetes favors infection, while infections make controlling diabetes much more difficult. The most frequent infections encountered in pregnant diabetics are those of the urinary tract (UTI) and cervicovaginal (CVI) area. Periodontal diseases (PD) and active caries (AC) are infectious diseases frequently found in these cases often remaining as hidden entities of low intensity. The aim of this study was to assess whether there is an association between PD and caries with lack of glycemic control often encountered in pregnant type 2 diabetic women. A single skilled researcher performed the periodontal evaluation of PD and AC cases. Glycated alpha hemoglobin (HbA 1c) over 6.5% was used to diagnose metabolic glucose disturbances. The controlled variables were UTI, CVI and adherence to treatment. The statistical tests used were chi-square adjusted for continuity, analysis of variance, odds ratio with 95% confidence intervals and logistic regression with a significance level of p <0.05. One hundred twenty-seven type 2 diabetic women were seen during the second trimester of their pregnancies. Mean age was 31.3 years; 55% had lack of glycemic control associated with CVI (χ 2 21.07, p <0.000), PD (χ 2 5.72, p <0.005) and UTI (χ 2 13.77, p <0.000) with therapeutic adherence (TA) (χ 2 14.80, p <0.00). No association was found with AC. The logistic regression results showed that UTI, CIV, PD and TA are associated with lack of glycemic control. Periodontal diseases may act as “hidden” infections in pregnant diabetics and be associated with lack of glycemic control. This situation should be taken into consideration by healthcare teams in charge of prenatal care.