Evaluation of Periodontal Status Among Saudi Females with Gestational Diabetes and its Relation to Glucose and Lipid Homeostasis in Ohud Hospital, Al Madina Al-Munwarrah

Objectives: Due to the lack of pregnant based oral health studies in our country, we conducted this study to evaluate periodontal status among females with gestational diabetes in Ohud Hospital, Al Madinah Al-Munwarrah and to assess its effect on insulin sensitivity and lipid metabolism. Methods: This cross-sectional descriptive study was conducted from January 2008 till June 2008. The sample includes 250 Saudi females, 100 were pregnant with gestational diabetes (GDM), and 100 were pregnant without GDM and 50 were normal non pregnant females. The study cases were matched age and body mass index. All the participants were subjected to history taking, physical examination and assessment of their periodontal status. Laboratory tests include fasting blood sugar, insulin levels, Homeostasis Model Assessment Insulin Resistance (HOMA-IR) test and serum lipids. Serum levels of inflammatory markers (CRP, ESR, IL-1 , and TNF- ) also measured. The periodontal health status was assessed using the Community Periodontal Index of Treatment Needs (CPITN). Results: Severe periodontal diseases were elicited in 37% of the pregnant females with GDM, 29% of the pregnant females without GDM and 14% of non pregnant normal control group. Females with GDM showed higher systolic and diastolic blood pressure, fasting insulin, HOMA-IR, serum lipids and serum inflammatory markers levels than the other groups. Serum fasting insulin levels, HOMA-IR, triglyceride levels, and serum inflammatory markers were higher in females with severe periodontal diseases. Females with recurrent GDM were found to have higher Body Mass Index (BMI), severe periodontal diseases, as well as higher HOMA-IR, than those presented for first time with GDM. Females with GDM; also shows significant positive correlation between CPITN scoring and patient age, HOMA-IR and inflammatory markers. Conclusions: The prevalence of periodontal disease is high among pregnant females especially those with GDM. Periodontal disease had important deleterious effects on carbohydrates and lipids metabolism. Strategies are needed to improve dental health care and to reduce periodontal diseases among pregnant females.