Effects of periodontal therapy on glucose management in people with diabetes mellitus

Aim. - The primary aim of this study was to examine the effects of intensive periodontal therapy on HbA(1c) in a mixed diabetes mellitus (DM) (types 1 and 2) population with moderate periodontitis (PD). Methods. - A total of 93 subjects with PD and DM, recruited from referrals to the Department of Endocrinology at the Perugia Hospital, were included in a follow-up cohort clinical study comprising two parallel periodontal therapy groups one receiving intensive periodontal therapy (IPT, n = 44) and the other serving as controls (CPT, n = 49) with an 8-month follow-up. Clinical periodontal examinations and blood samples were collected 4 and 8 months after the completion of therapy. Results. - The IPT group presented with greater reductions of all periodontal indices compared with the CPT group at both follow-ups (P < 0.001). Whereas, after 4 months, there were no major differences in HbA(1c) levels between groups, after 8 months, the IPT group presented with a 0.57% (95% CI: 0.12 to 1.09) greater reduction in HbA(1c) than the CPT group (P = 0.03). This reduction was independent of age, gender, smoking and body mass index. However, the,difference in HbA(1c) was greater in individuals with type 2 DM (0.95% reduction, 95% CI: 0.32 to 1.58; P = 0.004) compared with those with type 1 DM. Conclusion. - IPT resulted in greater improvement of gingival health in patients with DM. Improved oral health in those with type 2 DM may have an effect on medium-term glucose management and could possibly lead to long-term health benefits. (ISRCTN00559156). (C) 2011 Elsevier Masson SAS. All rights reserved.