Periodontal Treatment Doesn't Up Glycemic Control in T2DM
No significant difference in mean HbA1c levels with non-surgical periodontal tx among diabetes patients
WEDNEDAY, Dec. 18, 2013 (HealthDay News) -- For patients with type 2 diabetes and chronic periodontitis, non-surgical treatment is not associated with improved glycemic control, according to a study published in the Dec. 18 issue of the Journal of the American Medical Association.
In an effort to examine whether non-surgical periodontal treatment reduces HbA1c level, Steven P. Engebretson, D.M.D., from New York University in New York City, and colleagues conducted a randomized trial involving 514 participants with type 2 diabetes having a glycated hemoglobin (HbA1c) level of 7 to 9 percent and untreated chronic periodontitis. Scaling and root planing plus chlorhexidine oral rinse at baseline followed by supportive periodontal therapy at three and six months was provided for the treatment group (257 participants), while no treatment was given to the control group (257 participants) for six months.
Due to a futility analysis (no reasonable chance that the treatment arm would show a positive impact), enrollment in the trial was stopped early. The researchers found that the mean HbA1c levels increased in both groups (0.17 percent in the treatment group versus 0.11 percent in the control group), with no significant difference between the groups after adjustment for clinical site (mean difference, −0.05 percent; P = 0.55). At six months there was a significant improvement in periodontal measures in the treatment versus the control group, with adjusted between-group differences of 0.28 mm for probing depth, 0.25 mm for clinical attachment loss, 13.1 percent for bleeding on probing; and 0.27 for gingival index (P < 0.001 for all).
"These findings do not support the use of non-surgical periodontal treatment in patients with diabetes for the purpose of lowering levels of HbA1c," the authors write.
Several authors disclosed financial ties to the pharmaceutical, dental, and relevant consumer product industries.