Pre-diabetes and well-controlled diabetes are not associated with periodontal disease: the SHIP Trend Study Kowall B, Holtfreter B, V€ olzke H, Schipf S, Mundt T, Rathmann W, Kocher T. Pre-diabetes and well-controlled diabetes are not associated with periodontal disease: the SHIP Trend Study. J Clin Periodontol 2015; 42: 422–430. doi: 10.1111/jcpe.12391 Abstract Aim: To examine associations of pre-diabetes and well-controlled diabetes with periodontitis. Materials and Methods: The Study of Health in Pomerania (SHIP)-Trend is a cross-sectional survey in North-Eastern Germany including 3086 participants (49.4% men; age 20–82 years). Clinical attachment loss (CAL) and periodontal probing depth (PPD) were assessed applying a random half-mouth protocol. The number of teeth was determined. Pre-diabetes comprised impaired fasting glucose and impaired glucose tolerance. Previously known diabetes was defined as well controlled if glycated haemoglobin (HbA1c) was <7.0%. Participants were catego- rized as follows: normal glucose tolerance (NGT), pre-diabetes, newly detected type 2 diabetes (T2DM), known T2DM with HbA1c<7.0% and known T2DM with HbA1c≥7.0%. Results: Pre-diabetes was neither associated with mean CAL and PPD in multi- variable adjusted linear regression models nor with edentulism (OR = 1.09 (95%- CI: 0.69-1.71)) and number of teeth (OR = 0.96 (95%-CI: 0.75–1.22), lowest quartile versus higher quartiles) in logistic regression models. Associations with mean CAL and edentulism were stronger in poorly controlled previously known diabetes than in well-controlled previously known diabetes (for edentulism: OR = 2.19 (95%-CI: 1.18–4.05), and OR = 1.40 (95%-CI: 0.82–2.38), respec- tively, for comparison with NGT). Conclusions: Periodontitis and edentulism were associated with poorly controlled T2DM, but not with pre-diabetes and well-controlled diabetes. Bernd Kowall 1,2 , Birte Holtfreter 3 , Henry V€ olzke 4 , Sabine Schipf 4 , Torsten Mundt 5 , Wolfgang Rathmann 1 and Thomas Kocher 3 1 German Diabetes Center, Institute of Biometrics and Epidemiology, D€ usseldorf, Germany; 2 Center of Clinical Epidemiology, c/o Institute of Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital, Essen, Germany; 3 Unit of Periodontology, Department of Restorative Dentistry, Periodontology, and Endodontology, University Medicine, Ernst- Moritz-Arndt-University, Greifswald, Germany; 4 Institute for Community Medicine, University Medicine, Ernst-Moritz-Arndt- University, Greifswald, Germany; 5 Department of Prosthodontics, Gerodontology and Biomaterials, Dental School, University Medicine, Ernst-Moritz- Arndt-University, Greifswald, Germany Key words: diabetes mellitus; edentulous; glucose intolerance; hyperglycaemia; mouth; periodontal attachment loss; periodontal diseases; periodontitis; pre-diabetic state Accepted for publication 13 March 2015 Conflict of interest and source of funding statement The authors declare that there are no conflicts of interest in this study. This work is part of the research project Greifswald Approach to Individualized Medicine (GANI_MED). The GANI_MED consortium is funded by the Federal Ministry of Educa- tion and Research and the Ministry of Cultural Affairs of the Federal State of Mecklenburg – West Pomerania (03IS2061A). SHIP is part of the Community Medicine Research net (CMR) of the University of Greifswald, Germany, which is funded by the Federal Ministry of Education and Research (grant no. ZZ9603) and the Ministry of Cultural Affairs as well as the Social Ministry of the Federal State of Mecklenburg-West Pomerania (http://www.community-medicine.de). BH was supported by an unlimited educational grant from GABA, Switzerland. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd 422 J Clin Periodontol 2015; 42: 422–430 doi: 10.1111/jcpe.12391