Impact of periodontal treatment on diabetes management

Background + Aims

• Type 2 Diabetes Mellitus (T2DM) is prevalent in Hispanic populations, significantly affected by socioeconomic factors.
• Periodontitis, a chronic inflammatory disease, has been linked to worsened glycaemic management and increased number of diabetic complications.
• This study aims to evaluate whether non-surgical periodontal therapy (scaling and root planing (SRP)) improves glycated haemoglobin (HbA1c) levels and periodontal health in Hispanic individuals with T2DM and moderate-to-severe chronic periodontitis.

Materials + Methods

• Randomised controlled trial (RCT) with 154 participants split equally into a treatment group (SRP and oral hygiene education) and a control group (oral hygiene education only).
• Inclusion criteria included:
  • Hispanic adults aged ≥18 years
  • Diagnosed with T2DM
  • Moderate-to-severe chronic periodontitis
• Exclusions included:
  • Recent systemic antibiotic use
  • Recent dental treatment.
• The experimental group underwent SRP performed by trained periodontists, while controls received oral hygiene education. Periodontal parameters were assessed with calibrated periodontal probes.
• HbA1c was measured using a standardised boronate affinity assay.
• Both groups were re-evaluated 4–6 weeks after the baseline and again at 4 months.
• Outcomes:
  • Primary – change in HbA1c levels at 4 months.
  • Secondary – change in eriodontal parameters, including probing pocket depth (PPD), clinical attachment level (CAL), and bleeding on probing (BOP).
• Changes in HbA1c and periodontal parameters were compared using regression analysis and statistical tests, with significance set at p<0.05.

Results

• A total of 126 participants completed the study.
• The test and control groups demonstrated no significant differences in baseline characteristics.
• The reduction in HbA1c levels was greater in the experimental group (0.6%) compared to controls (0.3%), but the difference was not statistically significant.
• Significant improvements in periodontal health (reduction in PPD, CAL gain, and reduced BOP) were observed in the SRP group compared to controls.
• Both groups benefited from oral hygiene education, but SRP yielded stronger periodontal improvements.
• No significant correlation was found between reductions in HbA1c and periodontal parameters.

Limitations