Association between carotid intima-media thickness, buccodental status, and glycemic control in pediatric type 1 diabetes

Pediatric Diabetes, 05/17/2012

Gomez–Diaz RA et al. – More buccodental conditions and carotid intima–media thickness increase appeared in the patients with HbA1c level>8.5%, suggesting onset of atherosclerosis. The correlation between buccodental status and HbA1c values may indicate the connection between inflammatory states of atherosclerosis and type 1 diabetes.

Methods

  • Cross-sectional study with consecutive cases attended in an outpatient clinic (n=69).
  • Medical and clinical dental history, HbA1c, lipid profile, treatment period, and daily insulin dosage were recorded.
  • Sociodemographic data and anthropometrical measurements were obtained by standardized questionnaire.
  • Doppler real-time ultrasound was performed by a single experienced vascular radiologist blinded to the study.
  • Assessment of buccodental status was done by the Maxillofacial Unit of the Pediatrics Hospital, and an oral scrape culture was collected.

Results

  • The mean age was 11.7±3.0years, with diabetes 5.1±3.3years. Mean HbA1c was 8.5±1.7%.
  • Primary teeth were present in 52.2% and bacterial plaque in 94.2%.
  • Buccodental conditions featured caries (63.8%), gingivitis (84%), and enamel demineralization (26.1%): white spot lesions (18.8%) and cavitated lesions (7.3%).
  • Bacteria associated with caries were found in 44.1%. Patients in the highest HbA1c tertile had greater frequency of buccodental conditions and were positive for Streptococcus mutans and Candida albicans; also, cIMT increased and vessel compliance decreased compared to those in the lowest tertile.

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