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Is Periodontitis the Missing Link? A Metaethnographic Review of Glycemic Control Measures by Nigerian Diabetologists

Solomon O. Nwhator*,Michael A Adedigba

Diabetologists have always been aware of the adverse infect of infection on glycemic control. Periodontitis is a state of chronic subclinical inflammation exerting a similar adverse influence on glycemic control. The mortality of diabetes mellitus in Nigeria remains high despite attempts at “tight glycemic control” using diet, life style modification, oral hypoglycemic and insulin. Reported attainment of glycemic control is at times as low as 15%. The result of the failure in meeting glycemic control targets has taken in toll on the life of Nigerians and stretched our meager resources to the limits due to frequent admissions as a result hyperglycemic emergencies. These emergencies leave in their trail, reduced sexual function, microangiopathy and attendant end stage renal disease, blindness, limb amputations and death, Could lack of consideration for periodontitis be the missing link in the glycemic control protocols of Nigerian diabetologists? Using the search phrase Nigeria AND (diabetes OR diabetic OR diabetics), we conducted a search of existing literature in Cochrane Library, MEDLINE (PubMed), Mesh (MEDICAL SUBJECT HEADINGS (MeSH) databases. An initial number of 709 results were trimmed to 31 after application of inclusion criteria. We conducted a combination of metaethnography and narrative synthesis on the 31 studies and arrived at the hypotheses that the average Nigerian diabetologists appears UNAWARE of the link between glycemic control and periodontitis. Urgent training is recommended for Nigerian diabetologists through continuing education courses and collaboration with periodontologists.