Effect of non-surgical periodontal treatment on HbA1c levels in non-diabetic patients with chronic periodontitis in an Iranian population.

Fereshteh Naseralavi,Masumeh Nikkhah,Nastaran Etemadi,Ashkan Salari

doi:10.15171/japid.2019.013

Abstract

Background Evidence is limited on the effect of periodontal treatment on improving HbA1c levels in non-diabetic patients with chronic periodontitis. This study aimed to compare HbA1c levels in non-diabetic patients without periodontitis and nondiabetic patients with chronic periodontitis at baseline and to evaluate the effect of non-surgical periodontal treatment on glycemic control in non-diabetic chronic periodontitis patients. Methods In this interventional study, 30 non-diabetics, aged 35‒65 years, were selected and divided into two groups (n=15). Group A consisted of non-diabetics without periodontitis, and group B consisted of non-diabetics with mild to moderate chronic periodontitis. For all the subjects, periodontal parameters, including plaque index, gingival index, periodontal pocket depth, and clinical attachment loss, and laboratory parameters of FBS and HbA1c were measured and recorded. Independentsamples t-test was used to compare periodontal and laboratory parameters between the two groups; paired-samples t-test was used for intra-group comparisons.Results HbA1c level in group B (5.4±0.42%) was significantly higher than that in group A (5.04±0.43%) (P=0.03) at baseline. Three months after treatment, improvements were achieved in all the periodontal parameters in group B, with a significant decrease in HbA1c levels (P=0.006).Conclusion Non-surgical periodontal treatment resulted in a significant decrease in HbA1c levels in non-diabetic patients with chronic periodontitis. Although these levels did not reach the level of non-diabetic patients without periodontitis, it could be concluded that an improvement in the periodontal condition might lead to near-normal glycemic levels.

Highlights

Diabetes mellitus comprises a group of metabolic diseases identified by high blood glucose levels and an inability to produce or use insulin.[1]
The results showed that at baseline, HbA1c levels were significantly higher in nondiabetic subjects with mild to moderate chronic periodontitis compared to non-diabetic subjects without periodontitis
Many researchers have investigated the effect of periodontal non-surgical treatment on glycemic control status of diabetic patients with chronic periodontitis, and all have reported a significant decrease in HbA1c levels at follow-up.[31,32,33]

Summary

Introduction

Diabetes mellitus comprises a group of metabolic diseases identified by high blood glucose levels (hyperglycemia) and an inability to produce or use insulin.[1]. Type 2 diabetes mellitus is caused by environmental resistance to insulin action, impaired insulin secretion, and enhanced glucose production in the liver. Another type of diabetes is secondary hyperglycemia due to some diseases. Other types of secondary diabetes include diabetes associated with the diseases of the pancreas and the destruction of insulin-producing cells. Endocrine diseases, such as acromegaly and Cushing's syndrome, tumors, pancreatitis, and drugs that alter blood insulin levels, are all in this group.[2]. This study aimed to compare HbA1c levels in non-diabetic patients without periodontitis and nondiabetic patients with chronic periodontitis at baseline and to evaluate the effect of non-surgical periodontal treatment on glycemic control in non-diabetic chronic periodontitis patients

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Discussion

Conclusion