Among Pima Indians with type 2 diabetes, periodontal disease strongly predicts mortality from heart disease and kidney disease, according to a study published in the January issue of Diabetes Care.

Dr. Robert G. Nelson, of the National Institute of Diabetes and Digestive and Kidney Disease in Phoenix, Arizona, and colleagues studied 628 Pima Indians 35 years of age or older with type 2 diabetes.

The team used dental x-rays and examinations to see if the participants had periodontal disease, and classified it as none, mild, moderate, or severe. Overall, nearly 60 percent of the subjects had severe periodontal disease. Of these, 263 (70 percent) had lost all their teeth.

A total of 204 participants died during an average follow-up of 11 years. The death rates for all natural causes "expressed as the number of deaths per 1000 person-years of follow-up were 3.7 for no or mild periodontal disease, 19.6 for moderate disease, and 28.4 for severe periodontal disease," the investigators report.

The causes of death associated with periodontal disease were specifically heart disease and diabetes-related kidney disease.

"Periodontal disease is a major public health burden in Pima Indians, and it is a strong predictor of death from cardiorenal disease in those with type 2 diabetes," the researchers conclude.

SOURCE: Diabetes Care, January 2005.