Results

Participant's demographic characteristics

The study recruited 336 participants with a population median age of 56 (20, 91). Close to three-quarters (67.0%, 225/336) of the participants were females, and almost the same number of participants (67.3%, 226/336) had families either officially married or cohabiting. Less than half (45.5%, 153/336) of the participants had attained an elementary class. Slightly more than half (56.8%, 193/336) of participants were earning less than USD 2 per day, and less than one third (21.4%, 72/336) of participants had uncontrolled sugar levels, as shown in Table 1.

Variable | Frequency, N=336 (%)
Age (years)
Median (IQR) | 56 (20, 91)
Sex
Male | 111 (33)
Female | 225 (67)
Marital Status
Single | 13 (3.9)
Married/cohabiting | 226 (67.3)
Divorced | 18 (5.4)
Widowed | 79 (23.5)
Level of Education
No formal education | 85 (25.3)
Elementary school | 153 (45.5)
High school | 68 (20.2)
Tertiary | 30 (8.9)
Income Level
=< 2 USD per day | 193 (57.4)
>2 USD per day | 143 (42.6)
Glycemic Control
Controlled sugar levels | 264 (78.6)
Uncontrolled sugar levels | 72 (21.4)
Periodontal Disease
Normal | 26 (7.7)
Gingivitis | 123 (36.6)
Mild periodontitis | 16 (4.8)
Sever periodontitis | 171 (50.9)

Prevalence of periodontal disease among diabetic patients

Overall, the prevalence of periodontal disease was recorded at 92.3% (310/336). Almost a third (36.6%, 123/336) of the participants had gingivitis, a small proportion (4.8%, 16/336) had mild periodontitis, and half of the participants (50.9%, 171/336 ) had severe periodontitis. On the other hand, only (7.7%, 26/336) were normal without any form of periodontal disease, as shown in Figure 1.

Figure 1: Prevalence of periodontal disease among diabetic patients

Factors associated with periodontal disease among diabetic patients

Tables 2-3 show the factors associated with periodontal disease at bivariate and multivariate analysis, respectively. Results from this study showed that female participants had reduced odds of developing periodontal disease at bivariate analysis (OR: 0.244, 95%CI: 0.072-0.831, p = 0.024), and similar findings were statistically significant at the multivariate level (AOR: 0.170, 95%CI: 0.041-0.702, p = 0.014). Participants with tertiary education had much lower odds of developing periodontal disease at bivariate analysis (OR: 0.146, 95%CI: 0.034-0.629, p = 0.010). This finding was statistically significant at multivariate analysis (AOR: 0.151, 95%CI: 0.028-0.805, p = 0.027). Participants who consumed alcohol had slightly lower odds of developing periodontal disease compared to their counterparts at the bivariate level (OR: 0.230, 95%CI: 0.083-0.637, p = 0.005). Similar findings were statistically significant after adjustment (AOR: 0.109, 95%CI: 0.030-0.393, p = 0.001). Participants who visited a dental clinic twice a year had lower odds of developing periodontal disease as compared to their counterparts at the bivariate level (OR: 0.267, 95%CI: 0.761-0.935, p = 0.039). This finding was not statistically significant after adjustment (AOR: 0.296, 95%CI: 0.067-1.301, p = 0.107). Increasing age, smoking, and presence of comorbidities were associated with increased odds of developing periodontal disease at bivariate analysis (OR: 1.771, 95%CI: 0.766-4.094, p = 0.181; OR: 4.598, 95%CI: 0.608-34.740, p = 0.139; OR: 1.75, 95%CI: 0.783-3.910, p = 0.172, respectively); however, they were not statistically significant after adjustment (OR: 1.235, 95%CI: 0.461-3.304, p = 0.674; OR: 3.613, 95%CI: 0.380-34.321, p = 0.263; OR: 1.449, 95%CI: 0.628-4.094, p = 0.428, respectively).

Characteristics | Bivariate Analysis
Periodontal Disease | No Periodontal Disease | COR | 95%CI | P-value
Age (years)
Below 56 | 153 (90.0) | 17 (10.0) | 1
Above 56 | 157 (94.6) | 9 (5.4) | 1.938 | 0.838-4.481 | 0.122*
Sex
Male | 108 (97.3) | 3(2.7) | 1
Female | 202 (89.8) | 23(10.2) | 0.244 | 0.072-0.831 | 0.024*
Marital Status
Single | 8 (61.5) | 5 (38.5) | 1
Married/cohabiting | 213 (94.2) | 13 (5.8) | 10.240 | 2.934-35.736 | 0.0001
Divorced | 17 (94.4) | 1 (5.6) | 10.625 | 1.059-106.573 | 0.045
Widowed | 72 (91.1) | 7 (8.9) | 6.429 | 1.649-25.056 | 0.007
Income Level
=<2 USD per day | 180 (93.3) | 13 (6.7) | 1
>2 USD per day | 130 (90.9) | 13 (9.1) | 0.681 | 0.301-1.543 | 0.358
Level of Education
No formal education | 82 (96.5) | 3 (3.5) | 1
Elementary school | 144 (94.1) | 9 (5.9) | 0.585 | 0.154-2.223 | 0.432
High school | 60 (88.2) | 8 (11.8) | 0.274 | 0.699-1.078 | 0.064*
Tertiary | 24 (80.0) | 6 (20.0) | 0.146 | 0.034-0.629 | 0.010*
Diabetes Type
Type 1 | 91 (91.9) | 8 (8.1) | 1
Type2 | 218 (92.4) | 18 (7.6) | 1.060 | 0.445-2.525 | 0.896
Presence of Comorbidities
No | 124 (89.9) | 14 (10.1) | 1
Yes | 186 (93.9) | 12 (6.1) | 1.75 | 0.783-3.910 | 0.172*
Frequency of Tooth Brushing
No brushing | 40 (95.2) | 2 (4.8) | 1
Once a day | 185 (94.9) | 10 (5.1) | 0.949 | 0.200-4.501 | 0.947
Twice a day | 85 (85.9) | 14 (14.1) | 0.311 | 0.067-1.437 | 0.135*
Smoke
No | 262 (91.3) | 25 (8.7) | 1
Yes | 48 (98.0) | 1 (2.0) | 4.598 | 0.608-34.740 | 0.139*
Frequency of Dental Visits
Never | 165 (93.8) | 11 (6.2) | 1
Once a year | 125 (92.6) | 10 (7.4) | 0.833 | 0.343-2.024 | 0.687
Twice a year | 16 (80.0) | 4 (20.0) | 0.267 | 0.761-0.935 | 0.039*
More than thrice a year | 4 (80.0) | 1 (20.0) | 0.267 | 0.027-2.593 | 0.255
Alcohol Use
No | 290 (93.5) | 20 (6.5) | 1
Yes | 20 (76.9) | 6 (23.1) | 0.230 | 0.083-0.637 | 0.005*

Periodontal disease | AOR | 95%CI | P value
Age (years)
Belo 56 | 1
Above 56 | 1.235 | 0.461-3.304 | 0.674
Sex
Male | 1
Female | 0.169 | 0.410-0.702 | 0.014*
Education Level
No formal education | 1
Elementary school | 0.582 | 0.137-2.44 | 0.460
High school | 0.262 | 0.059-1.169 | 0.079
Tertiary | 0.151 | 0.028-0.805 | 0.027*
Presence of Comorbidities
No | 1
Yes | 1.449 | 0.579-3.623 | 0.428
Smoking
No | 1
Yes | 3.613 | 0.380-34.321 | 0.263
Alcohol Use
No | 1
Yes | 0.109 | 0.300-0.393 | 0.001*
Frequency of Dental Visits
Never | 1
Once a year | 0.981 | 0.379-2.534 | 0.968
Twice a year | 0.296 | 0.067-1.301 | 0.107
More than twice a year | 0.208 | 0.017-2.481 | 0.215