Clinical Trials Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. May 15, 2017; 8(5): 213-221
Published online May 15, 2017. doi: 10.4239/wjd.v8.i5.213
Nonsurgical periodontal-therapy improves glycosylated hemoglobin levels in pre-diabetic patients with chronic periodontitis
Rosamma Joseph, Meera Sasikumar, Jerry Mammen, M G Joseraj, Chandni Radhakrishnan
Rosamma Joseph, Meera Sasikumar, Jerry Mammen, Department of Periodontics, Government Dental College, Calicut 673008, Kerala, India
M G Joseraj, Department of Biochemistry, Government Medical College, Calicut 673008, Kerala, India
Chandni Radhakrishnan, Department of Internal Medicine, Government Medical College, Calicut 673008, Kerala, India
Author contributions: Joseph R has contributed to conception, study design, data analysis, intellectual content, interpretation of data and final approval of the manuscript; Sasikumar M has contributed to study design, data analysis, interpretation of data and manuscript drafting; Radhakrishnan C has contributed to study design, interpretation of data, intellectual content and final approval of the manuscript; Mammen J has contributed to data analysis, drafting and editing of the manuscript and language revision; Joseraj MG has contributed to acquisition, study design, interpretation of data and final approval of the manuscript; all authors approved the final version to be published.
Institutional review board statement: The study was reviewed and approved by the Institutional ethics committee, Government Dental College, Kozhikode on 13-12-2013 (IEC NO 27/2013).
Informed consent statement: All the study participants were explained about the study and informed written consent was obtained prior to study enrollment.
Conflict-of-interest statement: The authors declare that there are no conflicts of interest in this study. This study was supported by personnel funds of the authors.
Data sharing statement: No additional data available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Rosamma Joseph, Professor and Head, Department of Periodontics, Government Dental College, Medical College Campus, Calicut 673008, Kerala, India. drrosammajoseph@gmail.com
Telephone: +91-944-6070599 Fax: +91-495-2356781
Received: November 24, 2016
Peer-review started: November 27, 2016
First decision: January 16, 2017
Revised: February 25, 2017
Accepted: March 12, 2017
Article in press: March 13, 2017
Published online: May 15, 2017
Processing time: 171 Days and 17.2 Hours
Abstract
AIM

To evaluate the effect of nonsurgical periodontal therapy on glycosylated haemoglobin levels in pre-diabetic patients with chronic periodontitis (CHP).

METHODS

Sixty pre-diabetic patients with CHP were selected and equally allocated to case and control group. All subjects were evaluated at base line for periodontal parameters (plaque index, oral hygiene index, modified gingival index, probing pocket depth, clinical attachment level) and systemic parameters [glycosylated hemoglobin (HbA1c), fasting lipid profile, and fasting blood glucose]. The case group received non-surgical periodontal therapy. Subjects were re-evaluated for periodontal and systemic parameters after three months.

RESULTS

Both groups were comparable at baseline. Three months after non surgical periodontal therapy (NSPT), there was significant improvement in periodontal parameters in case group. The mean difference in systemic parameters like HbA1c and fasting plasma glucose from baseline to fourth month for case group was 0.22 ± 0.11 and 3.90 ± 8.48 respectively and control group was -0.056 ± 0.10 and -1.66 ± 6.04 respectively, which was significant between case and control group (P < 0.05). In the case group there was a significant decrease in HbA1c from baseline to three months following NSPT (P < 0.05).

CONCLUSION

This study showed that periodontal inflammation could affect the glycemic control in otherwise systemically healthy individuals. Periodontal therapy improved periodontal health status and decreased glycosylated haemoglobin levels, thus reducing the probability of occurrence of inflammation induced prediabetes in patients with CHP.

Keywords: Prediabetes; Chronic periodontitis; Non surgical periodontal therapy

Core tip: A bidirectional link exists between diabetes and periodontitis. Periodontitis may affect glycemic control in otherwise systemically healthy individuals resulting in an elevated glycosylated hemoglobin level. Pre diabetes may be associated with periodontal disease in systemically healthy subjects. This clinical trial evaluated the effect of non-surgical periodontal therapy on glycosylated hemoglobin levels in pre-diabetic patients with chronic periodontitis (CHP). This study showed that periodontal therapy improved periodontal health status and decreased glycosylated hemoglobin levels, thus reducing the probability of occurrence of inflammation induced prediabetes in patients with CHP.