The effect of periodontal therapy on uncontrolled type 2 diabetes mellitus in older subjects

Objective: The purpose of this study was to examine the effect of periodontal therapy on glycemic control in older type 2 diabetic patients. Methods: Fifty-two diabetic patients, age 55-80 years (mean age=61 years), with glycated hemoglobin (HbA1c) 7.5-11.0% (mean +/- s.d.=8.98 +/- 0.88) and severe periodontitis were included in the present study. The treatment group received mechanical periodontal treatment combined with systemic doxycycline, 100 mg day(-1) for 14 days. The control group received neither periodontal treatment nor systemic doxycycline. Clinical periodontal parameters, fasting plasma glucose (FPG), and HbA1c levels were measures at baseline and 3 months. Results: Periodontal treatment significantly improved periodontal status of the treatment group (P<0.05), however the reduction in the level of FPG and HbA1c did not reach significance. In the control group, no significant changes in clinical periodontal parameters, FPG and HbA1c levels were observed, except for significant increase in attachment loss (P<0.05). Comparing the two groups, although the 3-month level of HbA1c of the treatment group was lower than that of the control group, the difference did not reach significance. Conclusions: The results of the present study indicate that the periodontal condition of older Thais with uncontrolled diabetes is: (a) significantly improved 3 months after mechanical periodontal therapy with adjunctive systemic antimicrobial treatment, and (b) rapidly deteriorating without periodontal treatment. The effect of periodontal therapy on the glycemic control of older uncontrolled diabetics will require further studies that will have to include much larger sample sizes.