Association between carotid intima-media thickness, buccodental status, and glycemic control in pediatric type 1 diabetes


Corresponding author:

Rita A. Gómez Díaz MD,

Unidad de Investigación Médica en

Epidemiología Clínica,

UMAE Hospital de Especialidades,

CMN-SXXI, IMSS, Av. Cuauhtémoc

#330, Col. Doctores,

Deleg. Cuauhtémoc 06725

México, D.F., México.

Tel: (52–55)56276900x21481;

fax: (52–55)10541599;




To evaluate the association between carotid intima-media thickness, buccodental status, and glycemic control in patients with type 1 diabetes.


Cross-sectional study with consecutive cases attended in an outpatient clinic (n = 69). Medical and clinical dental history, HbA1c, lipid profile, treatment period, and daily insulin dosage were recorded. Sociodemographic data and anthropometrical measurements were obtained by standardized questionnaire. Doppler real-time ultrasound was performed by a single experienced vascular radiologist blinded to the study. Assessment of buccodental status was done by the Maxillofacial Unit of the Pediatrics Hospital, and an oral scrape culture was collected.


The mean age was 11.7 ± 3.0 years, with diabetes 5.1 ± 3.3 years. Mean HbA1c was 8.5 ± 1.7%. Primary teeth were present in 52.2% and bacterial plaque in 94.2%. Buccodental conditions featured caries (63.8%), gingivitis (84%), and enamel demineralization (26.1%): white spot lesions (18.8%) and cavitated lesions (7.3%). Bacteria associated with caries were found in 44.1%. Patients in the highest HbA1c tertile (>8.5%) had greater frequency of buccodental conditions and were positive for Streptococcus mutans and Candida albicans; also, cIMT increased and vessel compliance decreased compared to those in the lowest tertile (<7.0%) (p < 0.05).


More buccodental conditions and carotid intima-media thickness increase appeared in the patients with HbA1c level > 8.5%, suggesting onset of atherosclerosis. The correlation between buccodental status and HbA1c values may indicate the connection between inflammatory states of atherosclerosis and type 1 diabetes.