Predictors of periodontal disease among rural Indian type 2 diabetic population Anurag Yadav a , Golla Anmol Manaswini Yadav b , Kaveri NK c , Nanda Kumar LG c, * , Golla Srivats N. Yadav d , Ravi Kumar Akulwar e , Pradeep Digambar Myakalwar f a Department of Biochemistry, MNR Medical College, MNR Nagar, Sangareddy, Telangana, 502295, India b Department of General Medicine, Malla Reddy Institute of Medical Sciences, Hyderabad, India c Department of Physiology, MNR Medical College, MNR Nagar, Sangareddy, Telangana, 502295, India d Medico, Osmania Medical College, Hyderabad, India e Department of Prosthodontics Government Dental College and Hospital, St George Hospital Campus, PD Mello Road CST, Mumbai, 400001, India f Rural Hospital, Dharmabad, Nanded, Maharashtra, India article info Article history: Received 27 February 2020 Received in revised form 22 April 2020 Accepted 23 April 2020 Keywords: Periodontal disease (PD) HbA1c eGFR Type 2 diabetes mellitus abstract Background: Periodontal Disease (PD) is associated with complications of diabetes. Control of the PD reduces glycated hemoglobin (HbA1c) level. This study aimed to evaluate the relationship of PD with duration, severity of diabetes and eGFR. Material and method: A Prospective observational study conducted at Sidhi Vinayaka Hospitals (SVH) Sangareddy during the period of January 2014 to December 2019. Total 1436 patients with a definite diagnosis of type 2 diabetes (T2DM), between the ages of 45e60 years were included. They were clas- sified according to CPITN score for PD and compared against the variables. Results: A total of 1436 consecutive outpatients attending to SVH were included. Among them 662 (46.1%) were males and 774(53.9%) were females. The mean age of the patients was 48.3(SD ± 10.62) and mean duration of diabetes was 2.9(SD ± 4.18). The mean fasting blood glucose was 198.5(SD ± 85), mean post prandial blood glucose was 277.2 (SD ± 107.7) and mean HBA1c was 9.98% (SD ± 2.6). Among the study group 1198 (83.4%) had none/mild (Grade I) PD,192(13.4%) had moderate/severe (Grade II) PD and 46(3.2%) were completely edentulous (Grade III). Conclusion: There is a linear correlation between PD and age of patient, duration of diabetes, eGFR and level of glycemic status among rural population with T2DM. © 2020 Diabetes India. Published by Elsevier Ltd. All rights reserved. 1. Introduction Susceptibility to infection, poor wound healing and poor gingival health is common in patients with type 2 diabetes mellitus (T2DM), when compared to healthy subjects [1]. Periodontal dis- ease (PD) is associated with uncontrolled diabetes and other complications of diabetes and control of the periodontal infection reduces glycated hemoglobin (HbA1c) level [2e4]. PD is associated with risk of cardiovascular disease [5,6], retinopathy [7], nephropathy [8], neuropathy [9] and foot ulceration [10]. Most of the studies till date are on urban population and there is dearth of rural based studies. This is a clinic based rural study, directed to evaluate the relationship of periodontal disease with eGFR, duration and severity of T2DM. 2. Materials and methods This is a prospective observational study conducted at Sidhi Vinayaka Hospitals (SVH) Sangareddy after obtaining informed consent and ethics committee clearance (Ref No: MNR/2013/36 dated 24/08/2013) during the period of January 2014 to December 2019. 1436 patients with a definite diagnosis of T2DM according to ADA criteria [11], between the age of 45e60 years were included in the study as NHANES III demonstrated severity of PD increases with age >65 yrs [12, 13]. Patients with history of smoking, chewing * Corresponding author. E-mail addresses: yadav.anurag52@gmail.com (A. Yadav), anmolmanaswini@ gmail.com (G. Anmol Manaswini Yadav), dranusri@yahoo.com (K. NK), nandakumarlg@gmail.com (N.K. LG), gollasrivats@gmail.com (G.S.N. Yadav), akulwar@gmail.com (R.K. Akulwar), pradeepmyakalwar77@gmail.com (P.D. Myakalwar). Contents lists available at ScienceDirect Diabetes & Metabolic Syndrome: Clinical Research & Reviews journal homepage: www.elsevier.com/locate/dsx https://doi.org/10.1016/j.dsx.2020.04.034 1871-4021/© 2020 Diabetes India. Published by Elsevier Ltd. All rights reserved. Diabetes & Metabolic Syndrome: Clinical Research & Reviews 14 (2020) 463e467