CMHC Pulse Blog

A growing body of evidence is beginning to elucidate the dangers of undetected dysglycemia, revealing its connection to two common diseases – myocardial infarction (MI) and periodontitis (PD). 

Linked to severe tooth decay and loss, periodontal disease has also been associated with an increased risk of cardiometabolic conditions, including MI and stroke, as well as the development of Alzheimer’s disease. New research suggests that periodontal disease is commonly found in patients with undetected diabetes, and vice versa.

 Both myocardial infarction and PD are very common, with over 3 million cases of diagnosed periodontitis in the U.S. per year, and about 3 million heart attack events annually. According to the American College of Cardiology, an American adults suffers from a myocardial infarction approximately every 40 seconds. To date, little has been known about the relationship between undetected dysglycemia, myocardial infarction, and periodontitis, however, recent research aims to uncover the complex association.

 In a study published online in Diabetes Care, Swedish investigators examined the role of undetected dysglycemia as a risk factor  for the two common conditions.

Undetected Dysglycemia an Important Risk Factor for MI and PD

 Led by Dr. Anna Norhammar, from the Karolinska Institutet in Stockholm, a team of researchers examined the association between the three diseases in 805 patients with a first myocardial infarction and 805 matched control participants. Patients with diagnosed diabetes were excluded, leaving 712 MI patients and 731 controls. All participants without diabetes – which comprised 91% of the cohort – were examined with an oral glucose tolerance test.

 Abnormal glucose tolerance (AGT) or diabetes were categorized according to World Health Organization guidelines, while periodontal disease status was classified via dental X-rays as either healthy, moderate, or severe. Comparisons were made after adjusting for age, sex, smoking habits, education, and civil status.

 Researchers found abnormal glucose tolerance in 32% of MI patients, compared with 19% of control participants. Undetected dysglycemia was correlated to both MI and severe PD more strongly in patients than in the control cohort although, not when categorized as AGT. In addition, investigators found that severe periodontitis was more common in patients with undetected diabetes, as was undetected diabetes in patients with severe PD. MI patients were approximately twice as likely to have undetected dysglycemia than their control counterparts, according to the researchers. Their findings indicate a strong association between undetected dysglycemia and both MI and severe PD independently.

 Dr. Norhammar’s findings implicate the significant role of abnormal glucose levels as a risk factor for both severe periodontal disease and myocardial infarction. Moreover, the combination of severe PD and undetected diabetes was found to potentially further increase the risk of MI. The team’s results support previously known connections between PD and diabetes, revealing that the association is also related to undetected diabetes. This underscores the need for diabetes specialists and cardiologists to more closely approach patient dental health and collaborate with dentists to improve patient outcomes.


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