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The effect of periodontal treatment on metabolic control of type 1 diabetes mellitus

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Abstract

The objective of this investigation was to study the effect of nonsurgical periodontal treatment, with or without systemic administration of doxycycline, on the metabolic control of patients with type 1 diabetes. Sixty type 1 diabetic subjects with moderate to severe periodontitis were recruited. Periodontal parameters were measured, and blood samples were obtained to evaluate glycosylated hemoglobin (HbA1c). Group 1 (30 patients) was treated with scaling, root planning, and chlorhexidine rinses for 3 months in conjunction with systemic administration of doxycycline (100 mg once a day for 15 days). Group 2 (30 patients) received the same periodontal treatment but without the use of doxycycline. The paired Student t-test was used to detect differences between glycosylated hemoglobin means before and 3 months after periodontal treatment in group 1 and group 2 separately. Changes in mean HbA1c after treatment were 0.07% in group 1 and –0.06% in group 2, which were not statistically significant after 3 months. Significant changes were not found even in patients with the best response to periodontal treatment. Periodontal treatment in type 1 diabetic patients after 3 months follow-up did not improve metabolic control of diabetes as measured by glycosylated hemoglobin.

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Notes

  1. Adams TM, HA-8160, Menarini Diagnostics

  2. Itachi 747, Roche

  3. Cavitron, Dentsply Company, Madrid, Spain

  4. Gracey, HuFriedy Instruments, Chicago, IL, USA

  5. PerioAid 0.2%, Dentaid Company, Barcelona, Spain

References

  1. Aldridge JP, Lester V, Watts TLP, Collins A, Viberti G, Wilson RF (1995) Single-blind studies of the effects of improved periodontal health on metabolic control in Type 1 diabetes mellitus. J Clin Periodontol 22:271–275

    Article  PubMed  Google Scholar 

  2. American Diabetes Association (1993) Self-monitoring of blood glucose (consensus statement). Diabetes Care 16:60–65

    Google Scholar 

  3. American Diabetes Association (1997) Report of the expert committee on the diagnosis and classification of diabetes mellitus. Diabetes Care 20:1183–1197

    Google Scholar 

  4. American Diabetes Association (1998) Standards of medical care for patients with diabetes mellitus. Diabetes Care 21:23–31

    Article  Google Scholar 

  5. Cefalu WT, Bell-Farrow AD, Petty M, Izlar C, Smith JA (1991) Clinical validation of a second-generation fructosamine assay. Clin Chem 37:1252–1256

    PubMed  Google Scholar 

  6. Christgau M, Palitzsch KD, Schmalz G, Kreiner U, Frenzel S (1998) Healing response to non-surgical periodontal therapy in patients with diabetes mellitus: clinical, microbiological, and immunologic results. J Clin Periodontol 25:112–124

    Article  PubMed  Google Scholar 

  7. Cianciola LJ, Park BH, Bruck E, Mosovich L, Genco RJ (1982) Prevalence of periodontal disease in insulin-dependent diabetes mellitus (juvenile diabetes). J Am Dent Assoc 104:653–660

    PubMed  Google Scholar 

  8. Collin HL, Uusitupa M, Niskanen L et al (1998) Periodontal findings in elderly patients with non-insulin dependent diabetes mellitus. J Periodontol 69:962–966

    PubMed  Google Scholar 

  9. Feingold KR, Grunfeld C (1992) Role of cytokines in inducing hyperlipidemia. Diabetes 41:97–101

    PubMed  Google Scholar 

  10. Grossi SG, Skrepcinski FB, DeCaro T, Zambon JJ, Cummins D, Genco RJ (1996) Response to periodontal therapy in diabetics and smokers. J Periodontol 67:1094–1102

    PubMed  Google Scholar 

  11. Grossi SG, Skrepcinski FB, DeCaro T et al (1997) Treatment of periodontal disease in diabetics reduced glycated hemoglobin. J Periodontol 68:713–719

    PubMed  Google Scholar 

  12. Higgins PJ, Bunn HF (1981) Kinetic analsis of the nonenzymatic glycosylation of hemoglobin. J Biol Chem 256:5204–5208

    PubMed  Google Scholar 

  13. Iwamoto Y, Nishimura F, Nakagawa M et al (2001) The effect of antimicobial periodontal treatment on circulating tumor necrosis factor-alpha and glycated hemoglobin level in patients with type 2 diabetes. J Periodontol 72:774–778

    Article  PubMed  Google Scholar 

  14. Janket SJ, Wightman A, Baird AE, Van Dyke TE, Jones JA (2005) Does periodontal treatment improve glycemic control in diabetic patients? A meta-analysis of intervention studies. J Dent Res. 84:1154–1159

    PubMed  Google Scholar 

  15. Lacy PE (1995) Treating diabetes with transplanted cells. Sci Am 50:58–66

    Google Scholar 

  16. Ling PR, Istfan NW, Colon E, Bistrian BR (1995) Differential effects of interleukin-1 receptor antagonist in cytokine and endotoxin-treated rats. Am J Physiol 268:255–261

    Google Scholar 

  17. Llambés FA, Silvestre FD, Hernández AM, Guiha R, Caffesse RG (2005) Effect of non-surgical periodontal treatment with or without doxycycline on the periodontium of type 1 diabetic patients. J Clin Periodontol 32:915–920

    Article  PubMed  Google Scholar 

  18. Mealey B (1999) Diabetes mellitus. In: Rose LF, Genco RJ, Cohen DW, Mealey B (eds) Periodontal medicine. Decker, Ontario, pp 121–125

    Google Scholar 

  19. Miller LS, Manwell MA, Newbold D et al (1992) The relationship between reduction in periodontal inflammation and diabetes control: A report of 9 cases. J Periodontol 63:843–848

    PubMed  Google Scholar 

  20. Mine K, Nejat A, Elif U, Murat FE (2005) The effect of improved periodontal health on metabolic control in type 2 diabetes mellitus. J Clin Periodontol 32:266–272

    Article  Google Scholar 

  21. Nelson RG, Shlossman M, Budding LM et al (1990) Periodontal disease and NIDDM in Pima Indians. Diabetes Care 13:836–840

    Article  PubMed  Google Scholar 

  22. O’Leary TJ, Drake RB, Naylor JE (1972) The plaque control record. J Periodontol 43:38

    PubMed  Google Scholar 

  23. Rodrigues DC, Taba MJ, Novaes AB, Souza SL, Grisi MF (2003) Effect of non-surgical periodontal therapy on glycemic control in patients with type 2 diabetes mellitus. J Periodontol 74:1361–1367

    Article  PubMed  Google Scholar 

  24. Ryan ME, Ramamurthy NS, Golub LM (1998) Tetracyclines inhibit protein glycation in experimental diabetes. Adv Dent Res 12:152–158

    PubMed  Google Scholar 

  25. Sakallioglu EE, Aliyev E, Lütfioglu M, Yavuz U, Açikgöz G (2007) Vascular endothelial growth factor (VEGF) levels of gingiva and gingival crevicular fluid in diabetic and systemically healthy periodontitis patients. Clin Oral Investig 11:115–120

    Article  PubMed  Google Scholar 

  26. Sammalkorpi K (1989) Glucose intolerance in acute infections. J Intern Med 225:15–19

    Article  PubMed  Google Scholar 

  27. Seppälä B, Seppälä M, Ainamo J (1993) A longitudinal study on insulin-dependent diabetes mellitus and periodontal disease. J Clin Periodontol 20:161–165

    Article  PubMed  Google Scholar 

  28. Shapira L, Houri Y, Barak V, Soskolne WA, Halabi A, Stabholz A (1997) Tetracycline inhibits Porphyromonas gingivalis lipopolysaccharide-induced lesions in vivo and TNF-a processing in vitro. J Periodontal Res 32:183–188

    Article  PubMed  Google Scholar 

  29. Skaleric U, Schara R, Medvescek M, Hanlon A, Doherty F, Lessem J (2004) Periodontal treatment by Arestin and its effects on glycemic control in type 1 diabetes patients. J Int Acad Periodontol 6:160–165

    PubMed  Google Scholar 

  30. Smith GT, Greenbaum CJ, Johnson BD, Persson GR (1996) Short-term responses to periodontal therapy in insulin-dependent diabetic patients. J Periodontol 67:794–802

    PubMed  Google Scholar 

  31. Stewart JE, Wager KA, Friedlander AH, Zadeh HH (2001) The effect of periodontal treatment on glycemic control in patients with type 2 diabetes mellitus. J Clin Periodontol 28:306–310

    Article  PubMed  Google Scholar 

  32. Taylor GW, Burt BA, Becker MP et al (1996) Severe periodontitis and risk for poor glycemic control in patients with non-insulin-dependent diabetes mellitus. J Periodontol 67:1085–1093

    PubMed  Google Scholar 

  33. Taylor GW, Burt BA, Becker MP et al (1998) Non-insulin dependent diabetes mellitus and alveolar bone loss progression over 2 years. J Periodontol 69:76–83

    PubMed  Google Scholar 

  34. Taylor GW (2001) Bidirectional interrelationships between diabetes and periodontal diseases: An epidemiologic perspective. Ann Periodontol 6:99–112

    Article  PubMed  Google Scholar 

  35. Thorstensson H, Hugoson A (1993) Periodontal disease experience in adult long-duration insulin-dependent diabetics. J Clin Periodontol 20:352–358

    Article  PubMed  Google Scholar 

  36. Westfelt E, Rylander H, Blohme G, Jonasson P, Lindhe J (1996) The effect of periodontal therapy in diabetics. Results after 5 years. J Clin Periodontol 23:92–100

    Article  PubMed  Google Scholar 

  37. Wolf J (1977) Dental and periodontal conditions in diabetes mellitus. A clinical and radiographic study. Proc Finn Dent Soc 73:1–56

    PubMed  Google Scholar 

  38. Yki-Jarvinen H, Sammalkorpi K, Koivisto VA, Nikkila EA (1989) Severity duration and mechanism of insulin resistance during acute infections. J Clin Endocrinol Metab 69:317–323

    PubMed  Google Scholar 

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Acknowledgements

The authors wish to thank Dr. Daniel Bautista (Preventive Medicine Department, Dr. Peset Hospital) for his assistance in preparation of the statistical part of this manuscript, and the following for their technical assistance: Dra. Marisa Martinez Triguero (Laboratory, Dr. Peset Hospital), Isabel Soria (Endocrinology Department, Dr. Peset Hospital), and Leonor Alcover (Endocrinology Department, Dr. Peset Hospital).

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  1. Fernando Llambés

    Present address: , Paseo de la Pechina 51, esc2, pta3, 46018, Valencia, Spain

Authors and Affiliations

  1. Medically Compromised Patients Department, School of Dentistry, University of Valencia, Valencia, Spain

    Fernando Llambés & Francisco-Javier Silvestre

  2. Endocrinology Department, Dr. Peset Hospital, Valencia, Spain

    Antonio Hernández-Mijares

  3. Department of Periodontics, School of Dentistry, University of Houston, Houston, TX, USA

    Rami Guiha

  4. Department of Periodontics, School of Dentistry, University of Monterrey, Nuevo León, México

    Raúl Caffesse

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  1. Fernando Llambés
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  2. Francisco-Javier Silvestre
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  3. Antonio Hernández-Mijares
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  4. Rami Guiha
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  5. Raúl Caffesse
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Correspondence to Fernando Llambés.

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Llambés, F., Silvestre, FJ., Hernández-Mijares, A. et al. The effect of periodontal treatment on metabolic control of type 1 diabetes mellitus. Clin Oral Invest 12, 337–343 (2008). https://doi.org/10.1007/s00784-008-0201-0

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  • DOI: https://doi.org/10.1007/s00784-008-0201-0

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