TY - JOUR T1 - Association between diabetes and edentulism and their joint effects on health status in 40 low and middle-income countries JF - BMJ Open Diabetes Research & Care JO - BMJ Open Diab Res Care DO - 10.1136/bmjdrc-2021-002514 VL - 9 IS - 1 SP - e002514 AU - Louis Jacob AU - Jae Il Shin AU - Hans Oh AU - Guillermo F López-Sánchez AU - Lee Smith AU - Josep Maria Haro AU - Ai Koyanagi Y1 - 2021/10/01 UR - http://drc.bmj.com/content/9/1/e002514.abstract N2 - Introduction Previous studies on the diabetes–edentulism relationship have yielded conflicting results. Therefore, the goal of this study was to investigate the association between diabetes and edentulism, and their joint effects on health status in adults from 40 low and middle-income countries (LMICs).Research design and methods Data from the World Health Survey were used for this cross-sectional study (2002–2004). Forty countries (18 low-income and 22 middle-income countries) were included. Edentulism and diabetes were assessed using yes-no questions based on self-report. Health status was assessed in seven different domains (self-care, pain/discomfort, cognition, interpersonal activities, sleep/energy, affect, and perceived stress). The association between diabetes (exposure) and edentulism (outcome) was analyzed using multivariable logistic regression models, while their joint effects on health status were assessed using multivariable linear regression models.Results There were 175 814 adults aged ≥18 years included in this study (mean (SD) age 38.4 (16.0) years; 49.3% men). Overall, the prevalence of edentulism was 6.0% and diabetes was 2.9%. There was a positive and significant association between diabetes and edentulism in the overall sample (OR=1.40, 95% CI 1.18 to 1.66), in low-income countries (OR=1.78, 95% CI 1.21 to 2.62) and in middle-income countries (OR=1.24, 95% CI 1.04 to 1.47). In addition, people with comorbid diabetes and edentulism had worse health status in the domains of cognition, sleep/energy, and perceived stress, compared with those with diabetes only.Conclusions Diabetes was positively associated with edentulism in this sample of more than 175 000 individuals living in LMICs. Providing oral care to individuals with diabetes may potentially lead to a reduction in their risk of edentulism.Data are available in a public, open access repository. Data are available at: https://apps.who.int/healthinfo/systems/surveydata/index.php/catalog/whs/about ER -