What Is the Clinical Periodontal Condition of Patients With Diabetes Mellitus as Compared to Those Without?—A Synthesis of Systematic Reviews

FOCUSED QUESTION: What is the clinical periodontal condition of patients with diabetes mellitus (DM) as compared to those without DM (NDM) as gathered from existing systematic reviews (SRs)? METHODS: MEDLINE-PubMed and the Cochrane Library were searched from inception through September 2024 to identify eligible studies. SRs evaluating the periodontal condition of periodontitis patients with DM versus NDM were included. The primary outcome parameters of interest were Clinical Attachment level/loss (CAL) and Probing Pocket Depth (PPD). The secondary outcome were parameters of gingival inflammation, plaque and gingival recession. Characteristics, data and conclusions as presented in the selected SRs were extracted. The potential risk of bias was estimated, and a citation analysis was performed. The emerging evidence was summarized and grated. RESULTS: The search resulted in 488 unique titles and abstracts. After full text reading seven SRs were eligible for inclusion involving all together 154 underlying clinical studies. Of these 79 studies involved DM type I, 50 DM type II, 23 both types of DM and 2 studies without specification. For CAL the magnitude of the difference was estimated to be small to substantial for DM I and substantial for DM II and I/II. For PPD, the differences were estimated to be zero to moderate for DM I, moderate to substantial for DM II, and small to substantial for DM I/II. CONCLUSION: Regarding the impact of DM on periodontitis parameters, there is a moderate certainty for a small to substantial difference on CAL and zero to substantial difference for PPD as compared to NDM. There is weak evidence regarding the secondary parameters.