Oral health status and risk of incident diabetes: A prospective cohort study of 213,389 individuals aged 45 and over

Alice A Gibson; Emma Cox; Joanne Gale; Maria E Craig; Joerg Eberhard; Shalinie King; Clara K Chow; Stephen Colagiuri; Natasha Nassar

doi:10.1016/j.diabres.2023.110821

Oral health status and risk of incident diabetes: A prospective cohort study of 213,389 individuals aged 45 and over

Diabetes Res Clin Pract. 2023 Aug:202:110821. doi: 10.1016/j.diabres.2023.110821. Epub 2023 Jul 14.

Authors

Alice A Gibson¹, Emma Cox², Joanne Gale³, Maria E Craig⁴, Joerg Eberhard⁵, Shalinie King⁶, Clara K Chow⁷, Stephen Colagiuri⁸, Natasha Nassar⁹

Affiliations

¹ Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, NSW, Australia. Electronic address: alice.gibson@sydney.edu.au.
² Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, NSW, Australia.
³ Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.
⁴ Charles Perkins Centre, The University of Sydney, NSW, Australia; Discipline of Paediatrics & Child Health, School of Clinical Medicine, UNSW Medicine & Health, Sydney, NSW, Australia; Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.
⁵ Charles Perkins Centre, The University of Sydney, NSW, Australia; Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.
⁶ Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.
⁷ Charles Perkins Centre, The University of Sydney, NSW, Australia; Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Department of Cardiology, Westmead Hospital, NSW, Australia.
⁸ Charles Perkins Centre, The University of Sydney, NSW, Australia; The Boden Initiative, Charles Perkins Centre, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.
⁹ Menzies Centre for Health Policy and Economics, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, NSW, Australia; Charles Perkins Centre, The University of Sydney, NSW, Australia; Child Population and Translational Health Research, The Children's Hospital at Westmead Clinical School, Faculty of Medicine and Health, The University of Sydney, NSW, Australia.

PMID: 37453513
DOI: 10.1016/j.diabres.2023.110821

Abstract

Aims: To examine whether simple measures of oral health are associated with incident diabetes.

Methods: This prospective cohort study linked data from the 45 and Up Study, Australia, to administrative health records. The study participants were 213,389 men and women, aged ≥45 years, with no diabetes at baseline. The oral health of participants was assessed by questionnaire. Incident diabetes cases were ascertained based on self-report in follow-up questionnaires, linked data on medical and pharmaceutical claims, and hospitalisation data up until 2019. The association between oral health and incident diabetes were calculated using multivariable cox proportional hazards models.

Results: During 2,232,215 person-years of follow-up, 20,487 (9.6%) participants developed diabetes. Compared with those with ≥20 teeth, the adjusted hazard ratio (aHR) for incident diabetes was 1.12 (95% Confidence Interval (CI): 1.08, 1.17) for 10-19 teeth, 1.20 (1.14, 1.26) for 1-9 teeth and 1.15 (1.09, 1.21) for no teeth. Compared with those with excellent/very good teeth and gums, the aHR for incident diabetes was 1.07 (1.03, 1.12) for fair and 1.13 (1.07, 1.20) for poor teeth and gums.

Conclusions: Simple measures of oral health were associated with risk of developing diabetes, demonstrating the potential importance of oral health screening for diabetes prevention.

Keywords: Cohort study; Diabetes mellitus; Epidemiology; Oral health; Periodontitis; Tooth loss.

MeSH terms

Diabetes Mellitus* / epidemiology
Female
Humans
Incidence
Male
Oral Health*
Proportional Hazards Models
Prospective Studies
Risk Factors
Surveys and Questionnaires