Journal of Education and Health Promotion

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

Document Type : Original Article

Authors

. Chalini Sundar 1
. Sundar Ramalingam 2
. Viswanathan Mohan 3
. Rajendra Pradeepa 3
. M. J. Ramakrishnan 4

1 Department of Dental Public Health, Identiti Dental Centre Departments of 2 Research Support

2 Departments of Oral and Maxillofacial Surgery, College of Dentistry, King Saud University, Riyadh, Saudi Arabia

3 Departments of Diabetes Research

4 Departments of Dental, Dr. Mohan’s Diabetes Specialities Centre, “WHO Collaborating Centre for Non-communicable Diseases Prevention and Control, and ICMR Centre for Advanced Research on Diabetes”, Chennai, Tamil Nadu, India

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.

Keywords

Diabetes mellitus
glycemic control
hemoglobin A1c
periodontal therapy
periodontitis
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Journal of Education and Health Promotion
Volume 8, Issue 12
December 2018
Pages 1-7

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