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Lead author Ryan T. Demmer of the Columbia University Mailman School of Public Health said diabetes has long been believed to be a risk factor for periodontal infections. This is the first study exploring whether the reverse might also be true -- that periodontal infections can contribute to the development of diabetes.

The researchers studied more than 9,000 participants without diabetes from a nationally representative sample of the U.S. population, 817 of whom went on to develop diabetes. They then compared the risk of developing diabetes over the next 20 years among people with varying degrees of periodontal disease.

The study, published in Diabetes Care, found that individuals with elevated levels of periodontal disease were nearly twice as likely to become diabetic in that 20 year timeframe. The findings remained after extensive multivariable adjustment for potential confounders including, but not limited to, age, smoking, obesity, hypertension and dietary patterns.

"These data add a new twist to the association and suggest that periodontal disease may be there before diabetes", Demmer said in a statement.

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