Impact of Non-Surgical Periodontal Therapy on HbA1c Levels of Type 2 Diabetes at Khyber College of Dentistry, Peshawar: A Quasi-Experimental Study

Authors

  • Sadaf Saeed
  • Humayun Afridi
  • Tariq Ali Khan
  • Anhum Haroon Jadoon
  • Afnan Rehman
  • Somia Gul

DOI:

https://doi.org/10.36283/PJMD13-1/010

Keywords:

Diabetes Mellitus, Glycated Hemoglobin, Nonsurgical Periodontal Debridement

Abstract

Background: Diabetes mellitus (DM) constitutes a spectrum of persistent metabolic disorders originating from irregular glucose metabolism due to insufficient insulin production, compromised insulin function, or a combination of the two, leading to elevated blood sugar levels. This study assessed the influence of non-surgical periodontal therapy on glycated hemoglobin (HbA1c) levels in individuals with Type 2 Diabetes.

Methods: This quasi-experimental study was conducted at Khyber College of Dentistry, Peshawar, with 40 participants diagnosed with Type 2 diabetes for more than 3 years and suffering from chronic periodontitis. Patients with Type 1 diabetes, pregnant women, and those with other medical complications were excluded. HbA1c levels were assessed at baseline, and non-surgical periodontal therapy was administered. Patients were educated and scheduled for a follow-up after 3 months when HbA1c levels were reassessed. A paired t-test was employed to compare HbA1c levels pre-and post-intervention.

Results: In this study, males were 29 (58%) whereas 21 (42%) females. The mean value of HbA1c was less post-treatment with non-surgical periodontal therapy (6.928±0.866%) than pretreatment (9.048±0.73%) and results were statistically significant (p<0.001). After receiving therapy, the HbA1c level was significantly reduced in both genders (p<0.001).  Irrespective of smoking status, the reduction of HbA1c level was statistically significant (p=0.01).

Conclusion: Non-surgical periodontal treatment significantly reduces HbA1c levels, indicating a potentially positive impact on glycemic control in individuals with diabetes, which has enhanced the dentist’s role as a part of the health team, and timely interventions can significantly improve prognosis.

References

Lalla E, Papapanou PN. Diabetes mellitus and periodontitis : a tale of two common interrelated diseases. Nat Publ Gr. 2011;7(12):738–748. https://doi.org/10.1038/nrendo.2011.106

Löe H, Anerud A, Boysen H, Morrison E. Natural history of periodontal disease in man. J Clin Periodontol 1986;13(5):431-440. https://doi.org/10.1111/j.1600-051X.1986.tb01487.x

Milward M CI, Wright H, Millard J, Matthews J, Cooper P. Differential activation of NF-κB and gene expression in oral epithelial cells by periodontal pathogens. Clin Experim Immunol 2007;148(2):307-324. https://doi.org/10.1111/j.1365-2249.2007.03342.x

Page RC, Eke PI. Case definitions for use in population-based surveillance of periodontitis. J Periodontol 2007;78(7S):1387-1399 https://doi.org/10.1902/jop.2007.060264

Holtfreter B, Albandar JM, Dietrich T, Dye BA, Eaton KA, Eke PI, et al. Standards for reporting chronic periodontitis prevalence and severity in epidemiologic studies. J Clin Periodontol 2015;42(5):407-412 https://doi.org/10.1111/jcpe.12392.

Holtfreter B, Schwahn C, Biffar R, Kocher T. Epidemiology of periodontal diseases in the Study of Health in Pomerania. J Clin Periodontol 2009;36(2):114-123. https://doi.org/10.1111/j.1600-051X.2008.01361.x

Genco RJ, Falkner KL, Grossi S, Dunford R, Trevisan M. Validity of self-reported measures for surveillance of periodontal disease in two western New York population-based studies. J Periodontol 2007;78(7S):1439-1454. https://doi.org/10.1902/jop.2007.060435

Taylor GW, Borgnakke WS. Self-reported periodontal disease: validation in an epidemiological survey. J Periodontol 2007;78(7S):1407-1420. https://doi.org/10.1902/jop.2007.060481

Stewart JE, Wager KA, Friedlander AH, Zadeh HH. The effect of periodontal treatment on glycemic control in patients with type 2 diabetes mellitus. J Clin Periodontol. 2001;28(4):306-310. https://doi.org/10.1034/j.1600-051x.2001.028004306.x

Madianos PN, Koromantzos PA. An update of the evidence on the potential impact of periodontal therapy on diabetes outcomes. J Clin Periodontol. 2018;45(2):188-195. https://doi.org/10.1111/jcpe.12836

Salman S KK, Salman F, Hameed M. Effect of non-surgical periodontal treatment on glycemic control among type 2 diabetes mellitus patients with periodontitis. J Ayub Med Coll Abbott. 2016;28(4):742-745.

Llambés F, Silvestre F-J, Hernández-Mijares A, Guiha R, Caffesse R. The effect of periodontal treatment on metabolic control of type 1 diabetes mellitus. Clin Oral Investigat. 2008;12(4):337-343. https://doi.org/10.1007/s00784-008-0201-0

Smith GT, Greenbaum CJ, Johnson BD, Persson GR. Short-term responses to periodontal therapy in insulin-dependent diabetic patients. J Periodontol. 1996;67:794–802. https://doi.org/10.1902/jop.1996.67.8.794

Aldridge JP, Lester V, Watts TL, Collins A, Viberti G, Wilson RF. Single-blind studies of the effects of improved periodontal health on metabolic control in type 1 diabetes mellitus. J Clin Periodontol. 1995;22:271–275. https://doi.org/10.1111/j.1600-051X.1995.tb00147.x

Engebretson SP, Hyman LG, Michalowicz BS, Schoenfeld ER, Gelato MC, Hou W, Seaquist ER, Reddy MS, Lewis CE, Oates TW, et al. The effect of nonsurgical periodontal therapy on hemoglobin A1c levels in persons with type 2 diabetes and chronic periodontitis: a randomized clinical trial. JAMA. 2013;310:2523–2532. doi:10.1001/jama.2013.282431

Gay IC, Tran DT, Cavender AC, Weltman R, Chang J, Luckenbach E, Tribble GD. The effect of periodontal therapy on glycaemic control in a Hispanic population with type 2 diabetes: a randomized controlled trial. J Clin Periodontol. 2014;41:673–680. https://doi.org/10.1111/jcpe.12268

Faria‐Almeida R, Navarro A, Bascones A. Clinical and metabolic changes after conventional treatment of type 2 diabetic patients with chronic periodontitis. J Periodontol. 2006;77(4):591-598. https://doi.org/10.1902/jop.2006.050084

Dağ A, Firat ET, Arikan S, Kadiroğlu AK, Kaplan A. The effect of periodontal therapy on serum TNF-alpha and HbA1c levels in type 2 diabetic patients. Aust Dent J. 2009;54:17–22. https://doi.org/10.1111/j.1834-7819.2008.01083.x

Auyeung L, Wang PW, Lin RT, Hsieh CJ, Lee PY, Zhuang RY, Chang HW. Evaluation of periodontal status and effectiveness of non-surgical treatment in patients with type 2 diabetes mellitus in Taiwan for 1 year. J Periodontol. 2012;83:621–628. https://doi.org/10.1902/jop.2011.110133

Stratton IM AA, Neil HAW, Matthews DR, Manley SE, Cull CA, et al. Association of glycemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. Br Med J 2000;321(7258):405-412.

Keller DC. HbA1c, and blood glucose, changes when treating periodontal disease with the perio protect method™. Oral Health Dent Sci. 2023;7(1):1-8.

Published

2024-02-06

How to Cite

Saeed, S., Afridi, H., Khan, T. A., Jadoon, A. H., Rehman, A., & Gul, S. (2024). Impact of Non-Surgical Periodontal Therapy on HbA1c Levels of Type 2 Diabetes at Khyber College of Dentistry, Peshawar: A Quasi-Experimental Study. Pakistan Journal of Medicine and Dentistry, 13(1), 50–56. https://doi.org/10.36283/PJMD13-1/010

Most read articles by the same author(s)

Obs.: This plugin requires at least one statistics/report plugin to be enabled. If your statistics plugins provide more than one metric then please also select a main metric on the admin's site settings page and/or on the journal manager's settings pages.