A comparison of oral bacteriome isolated from periodontal pockets of participants with or without diabetes mellitus in Uganda: a case control study.

OBJECTIVE: Diabetes mellitus predisposes patients to increased incidence and severe forms of periodontal disease. Currently, information on the bacterial diversity of patients with diabetes mellitus and periodontitis in Uganda is scanty. This study set out to describe the bacteria associated with periodontitis in patients with diabetes mellitus in Uganda, as part of a larger study describing the association between periodontal disease and diabetes mellitus. RESULTS: This was a case control involving 45 samples of gingival crevicular fluid collected from participants with periodontitis, the cases being 26 participants with diabetes mellitus and controls 19 participants without diabetes mellitus. Sequencing using the 16s Oxford nanopore long read protocol was followed by a bioinformatics analysis pipeline for alpha and beta diversity indices in the two groups. Multivariate tests were done to determine the differences in the bacterial composition in the two groups. Of the 739 Operational Taxonomic Units and 500 phyla identified, 37.9% (280/739) were from participants with diabetes mellitus. Analysis of beta diversity revealed a dissimilarity between the two study groups (CAP score = 0) with a significant association noted between periodontitis and the subgingival bacteria (P = 0.001). Diabetes mellitus reduced the quantity and altered the composition of the subgingival microbiome in the study participants.

Periodontitis is associated with insulin resistance in adults living with diabetes mellitus in Uganda: a cross- sectional study.

INTRODUCTION: Evidence suggests that majority of patients with diabetes mellitus in Uganda have poor glycaemic control as well as periodontal disease. This study set out to determine the association between periodontitis and insulin resistance in adult patients with diabetes mellitus in Uganda using the triglyceride glucose index. METHODS: Two hundred and twenty-three adult study participants with confirmed diabetes mellitus were enrolled in a cross-sectional study. Oral examination was carried with the aid of a periodontal probe to determine the periodontal status and findings recorded using the WHO Oral Health Assessment Tool for Adults, 2013. We recorded clinical details for body mass index (BMI in kg/m2) and laboratory parameters including fasting blood sugar (mmol/L), glycated hemoglobin levels (HbA1c, %) and serum triglycerides (mmol/L) using a study questionnaire. Data were analyzed using R version 4.10. The glucose triglyceride index was used as a measure of insulin resistance. Logistic regression analysis carried out to determine the factors associated insulin resistance. RESULTS: The majority of the study participants was female (70%) with an average age of 48.5 years (SD+/- 11.1). The mean body mass index was 29.6 kg/m2 (SD+/- 5.82). The mean serum triglyceride index was 9.48 (SD+/- 0.675). Eighty-six-point 1% of the participants had periodontal disease. Bivariate analysis revealed high odds for male sex (OR = 1.31, 95% C.I = 0.44-4.84, p = 0.65) and periodontitis (OR = 3.65, 95% C.I = 0.79-26.15, p = 0.13) but low odds for a high BMI (OR = 0.45. 95% C.I = 0.07-1.67, p = 0.30). Multivariate regression revealed a significant association between insulin resistance and periodontitis. (AOR = 3.52, 95% C.I = 1.19-1.83, p = 0.03). CONCLUSION: Insulin resistance is highly prevalent in patients with diabetes mellitus in Uganda and is associated with periodontitis and low body weight.

Prevalence and factors associated with periodontal disease in patients with diabetes mellitus attending Kiruddu National Referral Hospital, Uganda.

Introduction: patients with diabetes mellitus present with high rates of periodontal disease. Severity and extent of periodontal disease may be directly associated with poor glycemic control. The burden of periodontal disease in patients with diabetes mellitus in Uganda is not documented. This study set out to determine the prevalence and factors associated with periodontal disease in patients with diabetes mellitus attending a national referral hospital in Uganda. Methods: this was a cross-sectional study involving 264 patients with diabetes mellitus. Data were collected using a pretested questionnaire to assess factors associated with periodontal disease. This was followed by an oral examination to determine the community periodontal index (CPI) and clinical attachment loss (CAL). Laboratory tests included glycated hemoglobin and fasting blood sugar. Factors associated with periodontal diseases were evaluated using logistic regression analysis. Results: of the 264 participants, 68.9% were females. The average age was 48.9 (SD = 11.0) years. Majority of the participants (32.6%) had diabetes mellitus for 2 to 5 years with oral hypoglycemic drugs being the most commonly (55.7%) used medication. The overall prevalence of periodontal disease was 85%. Univariate analysis revealed that prevalence of periodontal disease was associated with male sex, lower level of education, smoking, oral hygiene practices, poor glycemic control and combined diabetic medication. However, based on multivariate model, this prevalence was only significantly associated with lower level of education: aOR: 10.77 95% CI 1.04-226.38, p=0.05. Conclusion: periodontal disease is highly prevalent in patients with diabetes mellitus in Uganda, especially those with a lower level of education. All diabetic patients should be screened and managed for periodontal disease. Oral health interventions should also be packaged and presented in a simple language to allow easy comprehension by even the less educated population.