Association Between Periodontal Disease and Diabetes Mellitus in African Populations: A Case-Control Study

Abstract

Periodontal disease and diabetes mellitus represent two chronic conditions that have shown significant bidirectional relationships in global populations, yet their association remains inadequately explored within African contexts. This case-control study investigated the prevalence and severity of periodontal disease among diabetic patients compared to non-diabetic controls across multiple African populations. A total of 486 participants (243 cases with type 2 diabetes mellitus and 243 age-matched controls) were recruited from healthcare facilities in Kenya, Nigeria, and South Africa between January 2023 and December 2024. Clinical periodontal examinations included probing depth, clinical attachment loss, bleeding on probing, and plaque index measurements. Glycemic control was assessed through HbA1c levels. Results demonstrated that diabetic patients exhibited significantly higher prevalence of moderate to severe periodontitis compared to controls (odds ratio = 3.24, 95% CI: 2.18-4.82, p < 0.001). Poor glycemic control (HbA1c ≥ 7.5%) was associated with increased periodontal disease severity (p < 0.001). Multivariable logistic regression revealed that diabetes duration, glycemic control, and oral hygiene practices were independent predictors of periodontal disease. These findings underscore the necessity for integrated dental-medical care protocols for diabetic patients in African healthcare systems and highlight the importance of periodontal health screening in diabetes management programs across the continent.