Gestational Diabetes Mellitus and Periodontitis

Gestational Diabetes Mellitus (GDM) occurs in approximately 5% of pregnant women with onset during pregnancy, and subsiding after parturition. Importantly nearly 50% of women with GDM will eventually develop type 2 diabetes mellitus within 3-5 years post-partum. Substantial evidence is available documenting that the severity of periodontal disease is increased in patients with type 2 diabetes but limited data are available on the effects of GDM on periodontal health. Objective: To test the hypothesis that women with GDM are more likely to have periodontitis than women without GDM. Methods: The study group for this cross sectional evaluation consisted of 170 pregnant women, ages 17 to 46 classified as either having GDM (GDM+; n= 100) or not having GDM (GDM-; n=70). Women with a history of either type 1 or type 2 diabetes mellitus were excluded. All subjects received a comprehensive periodontal evaluation documenting plaque index, probing pocket depths, clinical attachment levels, bleeding on probing and presence of calculus. Subjects were classified as either having periodontal disease or not having periodontal disease, with the presence of periodontal disease being defined as at least 2 teeth with probing depth ³4mm, loss of clinical attachment ³2mm, and bleeding on probing. Multivariable logistic regression was used for analyses. Results: After controlling for plaque index, calculus index, cigarette smoking, age and race/ethnicity, women with GDM were 4 times more likely to have periodontitis than women without GDM (OR=4.049; 95% CI=1.5-10.8). Conclusions: Significant differences appear to exist in the extent and severity of periodontal inflammation and disease between GDM+ and GDM- subjects. Further analyses will determine if the combination of GDM and periodontal disease are associated with an increased negative impact on maternal and fetal health. Supported by: NIH/NCRR Center of Biomedical Research Excellence P20 RR020145 and the University of Kentucky GCRC M01 RR02602.