Correlation of periodontal inflamed surface area with glycemic status in controlled and uncontrolled type 2 diabetes mellitus

Table 1 Distribution of sociodemographic characteristics of patients

Sociodemographic characteristics		Group I	Group II	Group III	P value
Age, yr (mean ± SD)		48.83 ± 7.01	49.75 ± 5.99	50.87 ± 5.98	0.22
Gender (%)	Male	23 (38.33)	21 (35.00)	13 (21.67)	0.12
	Female	37 (61.67)	39 (65.00)	47 (78.33)
Socio-economic Status (%)	APL	18 (30.00)	25 (41.67)	13 (21.67)	0.06
	BPL	42 (70.00)	35 (58.33)	47 (78.33)

mean ± SD calculated for age for group I, group II and group III. APL: Above poverty line; BPL: Below poverty line.

Table 2 Comparison of glycemic status, oral hygiene status (Debris index–simplified, Calculus index–simplified, Oral hygiene index–simplified), bleeding on probing (% of site), probing pocket depth, clinical attachment loss, periodontal inflamed surface area and percentage of periodontitis among groups

Variables	Group I	Group II	Group III	P valuea
Duration of DM	8.95 ± 6.86	9.49 ± 6.873	13.67 ± 5.70	< 0.001
HbA1c	6.73 ± 0.25	8.87 ± 1.203	9.40 ± 1.54	< 0.001
FPG	117.25 ± 26.05	170.12 ± 57.86	173.67 ± 66.11	< 0.001
PPPG	176.55 ± 59.63	234.62 ± 79.34	242.17 ± 73.16	< 0.001
BOP (% of site)	55.31 ± 26.22	75.85 ± 22.72	79.14 ± 19.47	< 0.001
DI-S	1.08 ± 0.73	1.55 ± 0.78	1.6 ± 0.66	< 0.001
CI-S	1.31 ± 0.67	1.84 ± 0.71	1.94 ± 0.65	< 0.001
OHI-S	2.37 ± 1.35	3.39 ± 1.41	3.5 ± 1.14	< 0.001
PPD	2.59 ± 0.67	3.36 ± 0.77	3.43 ± 0.75	< 0.001
CAL	2.88 ± 0.77	3.81 ± 0.96	3.96 ± 0.92	< 0.001
PISA	852.22 ± 586.77	1506.5 ± 805.76	1530.05 ± 690.24	< 0.001
Periodontitis (%)	75	93.4	96.6	< 0.001

^aP < 0.001. mean ± SD. A significant difference among three groups for systemic and periodontal variables. DM: Diabetes mellitus; HbA1c: Glycated hemoglobin A1c; FPG: Fasting plasma glucose; PPBS: Postprandial plasma glucose, BOP: Bleeding on probing; DI-S: Debris index–simplified; CI-S: Calculus index–simplified; OHI-S: Oral hygiene index–simplified; PPD: Probing pocket depth; CAL: Clinical attachment loss; PISA: Periodontal inflamed surface area.

Table 3 Bonferroni post hoc analysis of probing pocket depth, clinical attachment loss and periodontal inflamed surface area among the study groups

Dependent variable	Group	Group	Mean difference	SE	Significant	95% confidence interval
						Upper bound	Lower bound
Mean PPD	I	II	0.76778	0.1330	0.000	1.089	0.4463
		III	0.83550	0.1330	0.000	1.157	0.5140
	II	III	0.06772	0.1330	1.00	0.3892	0.2538
Mean CAL	I	II	0.93488	0.1618	0.000	1.326	0.5438
		III	1.08697	0.1618	0.000	1.478	0.6959
	II	III	0.15208	0.1618	1.00	0.5432	0.2390
Mean PISA	I	II	654.278	127.80	0.000	963.166	345.391
		III	677.836	127.80	0.000	986.723	368.948
	II	III	23.557	127.80	1.00	332.444	285.330

Group I: Well-controlled T2DM; Group II: Uncontrolled T2DM group without microvascular complications; Group III: Uncontrolled T2DM group with microvascular complications. There was no significant difference between uncontrolled T2DM without microvascular complications group and uncontrolled T2DM group with microvascular complications for mean probing pocket depth, clinical attachment loss, and periodontal inflamed surface area (P = 1.00). SE: Standard error; PPD: Probing pocket depth; CAL: Clinical attachment loss; PISA: Periodontal inflamed surface area; T2DM: Type 2 diabetes mellitus.

Table 4 Percentage of sites with clinical attachment loss ≤ 3 mm, 4-5 mm and ≥ 6 mm among well-controlled type 2 diabetes mellitus group, uncontrolled type 2 diabetes mellitus group without microvascular complications and uncontrolled type 2 diabetes mellitus group with microvascular complications

Variable, CAL	Group I (% of site)	Group II (% of site)	Group III (% of site)	P valuea
CAL ≤ 3 mm	75.07	47.64	43.67	< 0.001
CAL 4-5 mm	22.16	37.53	38.43	< 0.001
CAL ≥ 6 mm	2.77	14.83	17.90	< 0.001

^aP < 0.001. A significant difference in percentage of sites with CAL ≤ 3 mm, 4-5 mm and ≥ 6 mm among well-controlled T2DM group, uncontrolled T2DM group without microvascular complications and uncontrolled T2DM group with microvascular complications. CAL: Clinical attachment loss; T2DM: Type 2 diabetes mellitus.

Table 5 Regression analysis

Model 1	Unstandardized coefficients		Standardized coefficients	t	P value
	B	SE	β
Constant	1558.557	1067.486		1.460	0.146
Age, yr	18.249	8.546	0.152	2.135	0.034a
Gender	89.509	141.724	0.055	0.632	0.529
Occupation	13.393	25.231	0.042	0.531	0.596
Socio-economic status	101.568	113.792	0.062	0.893	0.373
Smoking	173.619	145.772	0.094	1.191	0.235
Chew tobacco	171.018	272.268	0.044	0.628	0.531
Duration of diabetes	23.708	8.867	0.211	2.674	0.008a
Total dose of insulin	0.399	1.942	0.016	0.205	0.838
HbA1C	167.690	35.502	0.355	4.723	0.000a

^aP < 0.05. Dependent variable: Periodontal inflamed surface area (PISA). The multivariate linear regression model with dependent variable PISA showed that age, duration of diabetes, and glycated hemoglobin were significantly associated with PISA. B: Unstandardized coefficients; SE: Standard error; β: Standardized coefficients; HbA1c: Glycated hemoglobin A1c.