This retrospective cohort study evaluates the impact of periodontitis on cardiovascular and microvascular complications in patients with Type 2 Diabetes (T2D) using a large, global federated health research database. A total of 56,525 propensity score–matched T2D patients with and without periodontitis were followed for three years after the initiation of insulin therapy.

The findings show that periodontitis is associated with a significantly higher risk of adverse outcomes, including stroke, myocardial infarction, atrial arrhythmias, dementia, infective endocarditis, as well as diabetic microvascular complications such as retinopathy and nephropathy. Notably, overall mortality did not differ between the groups. The study concludes that periodontitis represents an additional and clinically relevant risk factor for long-term complications in individuals with T2D, underscoring the importance of incorporating periodontal screening and management into standard diabetes care. While limited by its retrospective and observational design, the study highlights the need for future prospective and interventional research to establish causality and assess the benefits of periodontal treatment in this population.

Essa, H., Welters, I. et al. Increased cardiovascular risk in people with type 2 diabetes and periodontitis: an analysis from a global real-world federated database. Br Dent J (2025).