Poor oral health (OH) manifested mainly as gingivitis/periodontitis is emerging as a serious diabetes complication. Recent reports suggest that poor OH may share pathogenic mechanisms with diabetic neuropathy (DN). We previously reported a high prevalence of poor OH in a large Romanian cohort of >1300 participants with diabetes phenotyped for OH and DN in 2016, particularly among participants with DN. This follow-up study aimed to further evaluate associations between DN and OH in this cohort over time. DN was assessed with the Michigan Neuropathy Scoring Instrument (MNSI), questionnaire (MNSIq) and clinical examination (MNSIe). Clinical DN was defined as MNSIe score of >2; symptomatic DN as MNSIq score of ≥4. OH was assessed using a validated questionnaire that includes questions about gingival pain, bleeding and complete dentures. OH was defined as good (no symptoms/signs), poor (symptoms/signs often/very often) or very poor (edentulous patients wearing complete dentures). Preliminary data is presented for 104 participants who completed a second evaluation in 2018/2019, median age (25th-75th percentile) 63 (59-70) years, 53% male, median diabetes duration 13 (8-17) years, mean A1c 7.8±1.5%. Among them 62 % presented with MNSIe>2 and 44 % with MNSIq>4. Poor and very poor OH at baseline (2016) were significantly correlated with MNSIe at follow-up (2018) (r = 0.20, p = 0.04). After adjusting for age and duration, there was a significant positive correlation between worsening in OH and DN (r = 0.26, p = 0.037) at follow-up. In multivariate analysis, after controlling for age and diabetes duration, there was a significantly higher change in the overall MNSI scores during follow-up in those with poor and very poor OH (0.97 +/- 1.9 vs. 0.16 +/- 1.8 p = 0.036). These data show that in this longitudinal cohort with diabetes DN worsened over time particularly in those with poor OH, suggesting that OH may directly affect risk of DN and other complications.


A. Jivanescu: None. C.I. Bondor: Consultant; Self; Wörwag Pharma. D. Sima: None. C.L. Vonica: Other Relationship; Self; AstraZeneca. D.T. Cosma: Other Relationship; Self; Wörwag Pharma. L. Steigmann: None. I. Veresiu: None. N. Gavan: None. A.V. Sarma: None. R. Pop-Busui: Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc. Consultant; Self; Bayer Healthcare Pharmaceuticals Inc., Novo Nordisk Inc. Research Support; Self; AstraZeneca. Other Relationship; Self; American Diabetes Association.


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