Associations Between Oral Health Status and Diabetic Neuropathy in a Large Romanian Cohort of Patients With Diabetes

Diabetic neuropathy (DN) and periodontal disease (PD) (gingivitis/periodontitis) are two serious chronic complications of diabetes with shared pathogenetic mechanisms (1,2). This cross-sectional study evaluated the association between DN and self-reported oral health (OH) status in a large cohort of Romanian patients with diabetes initially phenotyped in 2012 (3). Among these, patients who agreed to participate were included in the follow-up. The protocol was approved by the Ethics Committee for Scientific Research of the “Iuliu Haţieganu” University of Medicine and Pharmacy, Cluj-Napoca, Romania. OH was assessed using a three-item self-reported questionnaire that included the following questions: “Do you have complete dentures?” (yes/no), “In the last 6 months, how often have you experienced gingival pain?” (never/rarely/often/very often), and “In the last 6 months, how often have you experienced gingival bleeding?” (never/rarely/often/very often). OH was defined as good (no symptoms), average (experienced symptoms rarely), poor (experienced symptoms often/very often), or very poor (complete dentures). DN was assessed by trained diabetologists using the Michigan Neuropathy Screening Instrument (MNSI), comprising a questionnaire (MNSIq) and a clinical examination (MNSIe) (4,5). Clinical DN was defined as an MNSIe score of ≥2.5; symptomatic DN was defined as an MNSIq score of ≥4, or ≥2 for the reduced version of MNSIq (MNSIq4) (5). Proportions of different OH categories in patients with and without DN were compared using the χ …