The prevalence of oral Candida infections in periodontitis patients with type 2 diabetes mellitus

Abstract

Summary: Objectives: The purpose of this study was to determine the prevalence of Candida spp. in periodontitis patients with type 2 diabetes mellitus. Methods: This cross-sectional study included 42 diabetic patients with periodontitis (aged 21–70 years; 18 males and 24 females). Clinical measurements included probing pocket depth (PPD), clinical attachment level (CAL) and hemoglobin A1c (HbA1c) levels. Sub-gingival samples were collected from the mesio-buccal aspect of 3 teeth for fungal analysis. Candida species, including Candida albicans, Candida dubliniensis, Candida tropicalis and Candida glabrata, were identified using Gram staining, the germ tube test, CHROMagar, Staib agar and API 20C AUX. Results: The overall prevalence of Candida in diabetic patients with periodontitis observed in our study was 52%. The most common spp. of Candida identified were C. albicans (38%), followed by C. dubliniensis (9.5%), C. tropicalis (4.7%) and C. glabrata (4.7%). Compared to females, male patients were characterized by increased levels of Candida infections. Our results also indicate that individuals over the age of 40 had increased levels of Candida infections compared to patients younger than 40. Candida infections were higher among subjects with elevated blood sugar levels (HbA1c > 9) compared to individuals with well-controlled blood sugar levels (HbA1c < 6). Patients with PPDs ≥ 5 had an increased risk of Candida infection compared to patients with PPDs between 3 and 4. Conclusion: This study indicates that the frequency of C. albicans is higher than the frequencies of C. dubliniensis, C. tropicalis and C. glabrata in diabetic patients with periodontitis. Candida infections were observed at increased frequencies among subjects with high blood sugar levels and PPDs ≥ 5. Keywords: Diabetes, Infection, Candidiasis, Saudi Arabia