Periodontal therapy as an adjunctive modality for HbA1c reduction in type-2 diabetic patients

Abstract

OBJECTIVES This study aimed to evaluate the role of nonsurgical periodontal therapy in improving glycemic control among type 2 diabetes mellitus (T2DM) patients. MATERIALS AND METHODS Adult T2DM patients with mild-to-moderate periodontal disease, reporting to a tertiary care diabetes center in South India, from January to June 2014, were enrolled in the study. Medical management of T2DM along with diet and physical exercise was an inclusion criterion. Patients with factors affecting periodontal health and an inability to follow-up were excluded from the study. All patients underwent nonsurgical periodontal therapy (scaling, root planing, and irrigation of chlorhexidine [0.12%]). Periodontal status and glycated hemoglobin A1c (HbA1c) were assessed preoperatively and 6 months posttreatment. Dental status, diabetic history, and demographic characteristics were recorded to evaluate confounding roles. RESULTS A total of 266 T2DM patients (91 females/175 males; mean age 47.65 ± 5.93 years/range 25-55 years), fulfilling the inclusion criteria, were enrolled. The mean pre- and post-treatment HbA1c levels were respectively, 8.44 ± 1.87 and 7.98 ± 1.81, with a mean reduction of 0.46 ± 0.26 (P < 0.001). Significant HbA1c reduction (P < 0.001) was observed in patients with good pretreatment glycemic control (0.54 ± 0.26; 7.9%), regular follow-up (0.51 ± 0.28; 6.2%), and good oral hygiene (0.60 ± 0.49; 8.0%). CONCLUSION Nonsurgical periodontal therapy is associated with significant HbA1c reduction among T2DM patients with mild-to-moderate periodontitis after a 6-month follow-up period.