Effect of non-surgical periodontal therapy on insulin resistance and insulin sensitivity among individuals with borderline diabetes: A randomized controlled trial

Shinji Nishioka; Koutatsu Maruyama; Takeshi Tanigawa; Noriko Miyoshi; Eri Eguchi; Wataru Nishida; Haruhiko Osawa; Isao Saito

doi:10.1016/j.jdent.2019.04.005

Effect of non-surgical periodontal therapy on insulin resistance and insulin sensitivity among individuals with borderline diabetes: A randomized controlled trial

J Dent. 2019 Jun:85:18-24. doi: 10.1016/j.jdent.2019.04.005. Epub 2019 Apr 12.

Authors

Shinji Nishioka¹, Koutatsu Maruyama², Takeshi Tanigawa³, Noriko Miyoshi³, Eri Eguchi⁴, Wataru Nishida⁵, Haruhiko Osawa⁶, Isao Saito⁷

Affiliations

¹ Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine, Toon, Japan; Ehime Dental Association, Ehime, Japan.
² Laboratory of Community Health and Nutrition, Special Course of Food and Health Science, Department of Bioscience, Graduate School of Agriculture, Ehime University, Matsuyama, Japan.
³ Department of Public Health, Juntendo University Graduate School of Medicine, Tokyo, Japan.
⁴ Department of Public Health, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.
⁵ Nishida Wataru Diabetes Clinic, Matsuyama, Ehime, Japan.
⁶ Department of Diabetes and Molecular Genetics, Ehime University Graduate School of Medicine, Toon, Japan.
⁷ Department of Public Health and Epidemiology, Faculty of Medicine, Oita University 1-1 Idaigaoka, Hasama-machi, Yufu-shi Oita, 879-5593, Japan. Electronic address: saitoi@oita-u.ac.jp.

PMID: 30986513
DOI: 10.1016/j.jdent.2019.04.005

Abstract

Objective: To investigate the effect of non-surgical periodontal therapy on insulin resistance and sensitivity among individuals with borderline diabetes not receiving medications.

Methods: A crossover, randomized controlled trial was conducted among participants with borderline diabetes diagnosed by a 75-g oral glucose tolerance test. Participants were randomly assigned to either an early or later intervention group. The early intervention group underwent non-surgical periodontal therapy of scaling and root planing during the first 6 months, followed by a 6-month non-intervention period. The order was reversed in the later intervention group. Primary outcomes included: fasting or post-load serum glucose and insulin, body mass index (BMI), HOMA-IR, HOMA-β, and Matsuda Index.

Results: Seventy-four participants were randomized, and 71 participants completed the trial. There were no significant differences between groups in glucose and insulin concentrations during the intervention and non-intervention periods. When analyzed within groups by median-split of bleeding on probing (BOP) levels before intervention, the lower BOP group showed improved changes in BMI, HOMA-IR, HOMA-β, and Matsuda Index (P < 0.05). Further, we observed a positive correlation between baseline BOP and change in BMI (P = 0.06). Change in BMI was positively correlated with changes in HbA_1c, HOMA-IR, and HOMA-β (P < 0.05), and inversely correlated with change in Matsuda Index (P = 0.001).

Conclusions: Periodontal therapy had no significant effect on markers related to insulin and glucose metabolism among individuals with borderline diabetes. However, participants with a lower BOP (%) showed significant improvements in BMI, fasting serum insulin, HOMA-IR, HOMA-β and Matsuda Index.

Clinical significance: Among individuals diagnosed with borderline diabetes, those who had <37% of a lower BOP (%) showed potential improvements in BMI, fasting serum insulin, HOMA-IR, HOMA-β and Matsuda Index following non-surgical periodontal therapy.

Keywords: Borderline diabetes; Insulin resistance and sensitivity; Non-surgical periodontal therapy; Periodontitis; Randomized controlled trial.

Publication types

Randomized Controlled Trial
Research Support, Non-U.S. Gov't

MeSH terms

Blood Glucose
Body Mass Index
Diabetes Mellitus*
Diabetes Mellitus, Type 2
Fasting
Humans
Insulin
Insulin Resistance*
Periodontics*

Substances

Blood Glucose
Insulin