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Early markers of periodontal disease and altered oral microbiota are associated with glycemic control in children with type 1 diabetes
Author(s) -
Jensen Emilija D.,
Selway Caitlin A.,
Allen Gabrielle,
Bednarz Jana,
Weyrich Laura S.,
Gue Sam,
Peña Alexia S.,
Couper Jennifer
Publication year - 2021
Publication title -
pediatric diabetes
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.678
H-Index - 75
eISSN - 1399-5448
pISSN - 1399-543X
DOI - 10.1111/pedi.13170
Subject(s) - medicine , glycemic , bleeding on probing , type 2 diabetes , diabetes mellitus , dental plaque , gastroenterology , dentistry , gingival and periodontal pocket , clinical attachment loss , buccal swab , interquartile range , periodontitis , endocrinology , biology , genetics
Objectives To determine the relationship between periodontal disease and glycemic control in children with type 1 diabetes and to characterize the diversity and composition of their oral microbiota. Methods Cross‐sectional study including children with type 1 diabetes recruited from clinics at the Women's and Children's Hospital (Australia). Participants had a comprehensive dental assessment, periodontal examination, and buccal and gingival samples collected for 16S rRNA sequencing. Results Seventy‐seven participants (age 13.3 ± 2.6 years, 38 males, BMI z‐score 0.81 ± 0.75) had a diabetes duration of 5.6 ± 3.9 years and median HbA1c of 8.5% (range 5.8–13.3), 69.4 mmol/mol (range 39.9–121.9). Thirty‐eight (49%) had early markers of periodontal disease. HbA1c was positively correlated with plaque index (Rho = 0.34, P = 0.002), gingival index (Rho = 0.30, P = 0.009), bleeding on probing (Rho = 0.44, P = 0.0001) and periodontal pocket depth >3 mm (Rho = 0.21, P = 0.06). A 1% increase in HbA1c was independently associated with an average increase in bleeding on probing of 25% ( P = 0.002) and with an increase in the rate of sites with pocket depth >3 mm of 54% ( P = 0.003). Higher HbA1c was independently related to increased phylogenetic alpha diversity ( P = 0.008) and increased compositional variation (beta diversity P = 0.02) in gingival, but not buccal, microbiota. Brushing frequency, plaque index, and gingival index had a significant effect on microbiota composition, independent of HbA1c. Conclusions Children with type 1 diabetes showed a continuous relationship between less favorable glycemic control and increased early markers of periodontal disease. Glycemic control was also related to the complexity and richness of the plaque microbiota, with diversity increasing as HbA1c levels increase.