Undetected diabetes could lead to MI, gum disease

A collaboration between cardiologists and dentists at the Karolinska Institutet in Sweden has linked undetected glucose disorders like diabetes to an increased risk of myocardial infarction and periodontitis, a severe gum disease.

Study lead Anna Norhammar, a cardiologist and associate professor at the Karolinska Institutet, and colleagues said in Diabetes Care that while periodontitis is a known risk factor for MI and diabetes is more common in heart attack survivors, researchers are less certain of how undetected dysglycemia—a reduced ability to metabolize sugar—impacts either condition on its own. Having previously established connections between periodontitis, MI and lowered glucose tolerance in previous projects, her team launched a study of nearly 1,500 patients with a focus on undetected glucose disorders.

Norhammar et al.’s work was based on the existing PAROKRANK study and included 712 patients from 17 Swedish cardiology clinics and 731 controls matched for age, sex and post code. The researchers assessed individuals’ periodontitis status with X-rays and their dysglycemic status with glucose load tests, excluding any patients with a formal diabetes diagnosis.

Patients were divided based on their glucose tolerance and labeled as having either normal glucose, reduced glucose tolerance or newly detected diabetes. After adjusting for age, sex, smoking habits, education and civil status, Norhammar’s team found previously undetected glucose disorders, like diabetes and impaired glucose tolerance, were associated with an increased incidence of MI.

The study found it was twice as common for heart attack patients to have undetected dysglycemia compared to healthy controls, confirming results from Norhammar et al.’s previous work.

“Our findings indicate that dysglycemia is a key risk factor in both severe periodontitis and myocardial infarction and that the combination of severe periodontitis and undetected diabetes further increases the risk of myocardial infarction,” Norhammar said in a statement.

She said the study is limited in that the number of patients and controls with severe periodontitis and undetected diabetes was low, but it’s a jumping-off point for more integrated care.

“Our study shows that undetected glucose disorders are common in two major diseases—myocardial infarction and periodontitis,” Norhammar said. “Many people visit the dentist regularly and maybe it’s worth considering taking routine blood sugar tests in patients with severe periodontitis to catch these patients."