The Effect of Periodontal Intervention on HbA1c Levels in Patients with Type 2 Diabetes Mellitus: A Randomized Controlled Study

牙周干预对2型糖尿病患者糖化血红蛋白(HbA1c)水平的影响:一项随机对照研究

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Abstract

BACKGROUND: Periodontal diseases, initiated by microbial plaque biofilm, are inflammatory conditions affecting the supporting structures of teeth. Diabetes mellitus is a significant risk factor for periodontitis, and a bidirectional relationship exists where chronic periodontal inflammation may impair glycemic control. However, the impact of periodontal treatment on glycemic outcomes remains inconclusive. This study aimed to assess the effect of non-surgical periodontal therapy on metabolic control, as measured by HbA1c levels, in patients with type 2 diabetes and mild-to-moderate generalised chronic periodontitis. MATERIALS AND METHODS: A randomized controlled clinical trial was conducted at the Department of Periodontology, Manipal College of Dental Science, Manipal, Karnataka, India, with ethical clearance from the Institutional Ethics Committee (IEC No. 151/2011). One hundred eligible participants, aged 30 to 70 years, diagnosed with type 2 diabetes (HbA1c 6.5-7.5%) and mild to moderate chronic periodontitis (clinical attachment loss [CAL] 1-4 mm per AAP 1999 classification), were recruited. Participants were randomized into two groups (n = 50 each): a test group receiving non-surgical periodontal therapy (scaling and root planing) and a control group receiving no periodontal intervention. HbA1c levels were assessed at baseline and 3 months using high performance liquid chromatography. Clinical periodontal parameters (plaque index, gingival index, modified sulcus bleeding index, CAL, and probing pocket depth) were also assessed. Data were analysed using SPSS version 14, with paired t-tests for within-group comparisons and independent t-tests for intergroup differences, with P < 0.05 considered statistically significant. Results and. CONCLUSION: The test group showed greater improvements in all periodontal parameters compared to controls, though HbA1c levels did not differ significantly over three months. Overall, the findings indicate a modest link between better periodontal health and a slight HbA1c reduction in well-controlled diabetes.

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