Does periodontal care improve glycemic control? The Department of Veterans Affairs Dental Diabetes Study

J Clin Periodontol. 2007 Jan;34(1):46-52. doi: 10.1111/j.1600-051X.2006.01002.x. Epub 2006 Nov 24.

Abstract

Objectives: Report results of a randomized-clinical trial of the efficacy of periodontal care in the improvement of glycemic control in 165 veterans with poorly controlled diabetes over 4 months.

Methods: Outcomes were change in Haemoglobin A1c (HbA1c) in the Early Treatment versus untreated (Usual Care) groups and percent of participants with decreases in HbA1c. Analyses included simple/multiple variable linear/logistic regressions, adjusted for baseline HbA1c, age, and duration of diabetes.

Results: Unadjusted analyses showed no differences between groups. After adjustment for baseline HbA1c, age, and diabetes duration, the mean absolute HbA1c change in the Early Treatment group was -0.65% versus -0.51% in the Usual Care group (p=0.47). Adjusted odds for improvement by 0.5% in the Early Treatment group was 1.67 (95% confidence interval: 0.84, 3.34, p=0.14). Usual Care subjects were twice as likely to increase insulin from baseline to 4 months (20% versus 11%, p=0.12) and less likely to decrease insulin (1% versus 6%, p=0.21) than Early Treatment subjects. Among insulin users at baseline, more increased insulin in the Usual Care group (40% versus 21%, p=0.06).

Conclusions: No significant benefit was found for periodontal therapy after 4 months in this study; trends in some results were in favour of periodontal treatment.

Publication types

  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Age Factors
  • Anti-Bacterial Agents / therapeutic use
  • Anti-Infective Agents, Local / therapeutic use
  • Blood Glucose / analysis
  • Chlorhexidine / analogs & derivatives
  • Chlorhexidine / therapeutic use
  • Dental Scaling
  • Diabetes Mellitus, Type 2 / blood*
  • Diabetes Mellitus, Type 2 / prevention & control
  • Doxycycline / therapeutic use
  • Female
  • Follow-Up Studies
  • Glycated Hemoglobin A / analysis
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Insulin / therapeutic use
  • Male
  • Middle Aged
  • Patient Compliance
  • Periodontal Diseases / therapy*
  • Root Planing
  • Time Factors
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Anti-Infective Agents, Local
  • Blood Glucose
  • Glycated Hemoglobin A
  • Hypoglycemic Agents
  • Insulin
  • chlorhexidine gluconate
  • Doxycycline
  • Chlorhexidine