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Abstract

Abstract Background Diabetes mellitus and periodontal disease share a bidirectional relationship, yet oral-health concerns are often inadequately integrated into diabetes care. Evidence regarding patients’ knowledge, attitudes, and practices (KAP) concerning this relationship remains limited in Bangladesh. This study assessed KAP related to periodontal health and diabetes mellitus among Bangladeshi adults living with diabetes. Methods A quantitative cross-sectional study was conducted between January and July 2026 among adults with diabetes recruited from Bangladesh’s eight administrative divisions using convenience sampling. Data were collected through a pretested, bilingual semi-structured questionnaire administered face-to-face or electronically. The questionnaire assessed sociodemographic and clinical characteristics and included six knowledge, six attitude, and eleven practice items. Descriptive statistics, chi-square tests, independent-samples t tests, Pearson correlations, linear regression, and logistic regression were performed. Results Of 396 respondents, 331 with complete data were analyzed. Participants had a mean age of 52.99 ± 13.60 years. The mean knowledge score was 2.46 ± 1.88 of 6; 18.4% demonstrated good knowledge, whereas 71.6% had poor knowledge. In contrast, attitudes were comparatively favorable: the mean attitude score was 8.85 ± 2.52, with 48.6% classified as positive and 17.2% as negative. Despite 97.3% reporting tooth cleaning, only 13.9% demonstrated good oral-health practices and 48.6% had poor practices. Awareness was highest for food impaction (68.6%) but lowest for tooth elongation (23.3%). Attitude and practice scores showed a moderate positive correlation ( r  = 0.394, p  < 0.001), while knowledge was not significantly correlated with either domain. Knowledge varied significantly by geographic division, whereas practice scores were lower among older participants and those reporting poorer health. In adjusted analyses, Dhaka residence was associated with higher odds of good practice (adjusted odds ratio 4.67, 95% CI 1.02–21.41; p  = 0.047). Conclusions Bangladeshi adults with diabetes showed a substantial knowledge–practice gap despite generally favorable attitudes toward oral health. Diabetes services should incorporate structured periodontal health education, preventive dental referrals, and practical oral hygiene counseling, particularly for older adults and populations with limited access to integrated care.