Glycemic control appears to have a significant impact on the relationship between periodontitis and diabetes. The current study aimed to investigate the association between the stage of periodontitis and hemoglobin A1c (HbA1c) levels in patients considered to be normoglycemic. A total of 135 patients (100 females and 35 males) with no history of diabetes were included in the study. The mean age of the participants was 38.4 years old. All patients underwent a full-mouth periodontal examination. Periodontal diagnosis was determined according to the 2017 World Workshop on the Classification of Periodontal Disease. The glycemic state of the patients was assessed using a chair-side HbA1c analyzer. Ninety patients were diagnosed with periodontitis. Higher average HbA1c levels were associated with the different stages of periodontitis (p<0.01). Most of the non-periodontitis patients were in the non-diabetes group (67%), while most of the periodontitis patients were in the undiagnosed pre-diabetes group (47% of the stages I and II group, and 44% of the stages III and IV groups) (p<0.001). Periodontitis was found to be significantly associated with elevated glycated hemoglobin levels in patients not previously diagnosed with diabetes, and the elevation in HbA1c levels was more evident in patients with stage III and IV periodontitis.
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