Gum disease raises death risk in diabetics: study

NEW YORK (Reuters Health) - Severe gum disease may hasten death in people with diabetes, new study findings suggest.

"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," said study author Dr. William C. Knowler.

The findings underscore the need for good oral hygiene in diabetics, who are particularly prone to periodontitis, or gum disease, Knowler said in an interview with Reuters Health.

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 a recent meeting of the American Diabetes Association in New Orleans.

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.