Periodontal therapy and glycaemic control among individuals with type 2 diabetes

reflections from the PerioCardio study

Kostas Kapellas, Gloria C Mejia, P. Mark Bartold, Michael Skilton, Louise Maple-Brown, Gary Slade, Kerin O'Dea, A Brown, David Celermajer, Lisa Jamieson

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Objectives: Diabetes mellitus and periodontal disease are highly prevalent among Indigenous Australian adults. Untreated periodontitis impacts glycaemic control in people with diabetes. The aim of this study was to report on the effect of periodontal therapy on glycaemic control among people with obesity.

    Methods
    : This subgroup analysis is limited to 62 participants with diabetes from the original 273 Aboriginal Australian adults enrolled into the PerioCardio study. Intervention participants received full-mouth non-surgical periodontal scaling during a single, untimed session while controls were untreated. Endpoints of interest included change in glycated haemoglobin (HbA1c), C-reactive protein (CRP) and periodontal status at 3 months post-intervention.

    Results
    : There were more females randomized to the treatment group (n = 17) than control (n = 10) while the control group had a higher overall body mass index (BMI) [mean (SD)] 33.1 (9.7 kg m−2) versus 29.9 (6.0 kg m−2). A greater proportion of males were followed up at 3 months compared to females, P = 0.05. Periodontal therapy did not significantly reduce HbA1c: ancova difference in means 0.22 mmol mol−1 (95% CI −6.25 to 6.69), CRP: ancova difference in means 0.64 (95% CI −1.08, 2.37) or periodontal status at 3 months.

    Conclusions
    : Non-surgical periodontal therapy did not significantly reduce glycated haemoglobin in participants with type 2 diabetes. Reasons are likely to be multifactorial and may be influenced by persistent periodontal inflammation at the follow-up appointments. Alternatively, the BMI of study participants may impact glycaemic control via alternative mechanisms involving the interplay between inflammation and adiposity meaning HbA1c may not be amenable to periodontal therapy in these individuals.
    Original languageEnglish
    Pages (from-to)42-51
    Number of pages10
    JournalInternational Journal of Dental Hygiene
    Volume15
    Issue number4
    Early online date1 Jun 2016
    DOIs
    Publication statusPublished - Nov 2017

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    Type 2 Diabetes Mellitus
    Glycosylated Hemoglobin A
    C-Reactive Protein
    Body Mass Index
    Hemoglobin C
    Inflammation
    Therapeutics
    Periodontitis
    Adiposity
    Periodontal Diseases
    Mouth
    Diabetes Mellitus
    Appointments and Schedules
    Obesity
    Control Groups

    Cite this

    Kapellas, Kostas ; Mejia, Gloria C ; Bartold, P. Mark ; Skilton, Michael ; Maple-Brown, Louise ; Slade, Gary ; O'Dea, Kerin ; Brown, A ; Celermajer, David ; Jamieson, Lisa. / Periodontal therapy and glycaemic control among individuals with type 2 diabetes : reflections from the PerioCardio study. In: International Journal of Dental Hygiene. 2017 ; Vol. 15, No. 4. pp. 42-51.
    @article{1f70f620acd549b4a0514a866a57b3cd,
    title = "Periodontal therapy and glycaemic control among individuals with type 2 diabetes: reflections from the PerioCardio study",
    abstract = "Objectives: Diabetes mellitus and periodontal disease are highly prevalent among Indigenous Australian adults. Untreated periodontitis impacts glycaemic control in people with diabetes. The aim of this study was to report on the effect of periodontal therapy on glycaemic control among people with obesity.Methods: This subgroup analysis is limited to 62 participants with diabetes from the original 273 Aboriginal Australian adults enrolled into the PerioCardio study. Intervention participants received full-mouth non-surgical periodontal scaling during a single, untimed session while controls were untreated. Endpoints of interest included change in glycated haemoglobin (HbA1c), C-reactive protein (CRP) and periodontal status at 3 months post-intervention.Results: There were more females randomized to the treatment group (n = 17) than control (n = 10) while the control group had a higher overall body mass index (BMI) [mean (SD)] 33.1 (9.7 kg m−2) versus 29.9 (6.0 kg m−2). A greater proportion of males were followed up at 3 months compared to females, P = 0.05. Periodontal therapy did not significantly reduce HbA1c: ancova difference in means 0.22 mmol mol−1 (95{\%} CI −6.25 to 6.69), CRP: ancova difference in means 0.64 (95{\%} CI −1.08, 2.37) or periodontal status at 3 months.Conclusions: Non-surgical periodontal therapy did not significantly reduce glycated haemoglobin in participants with type 2 diabetes. Reasons are likely to be multifactorial and may be influenced by persistent periodontal inflammation at the follow-up appointments. Alternatively, the BMI of study participants may impact glycaemic control via alternative mechanisms involving the interplay between inflammation and adiposity meaning HbA1c may not be amenable to periodontal therapy in these individuals.",
    author = "Kostas Kapellas and Mejia, {Gloria C} and Bartold, {P. Mark} and Michael Skilton and Louise Maple-Brown and Gary Slade and Kerin O'Dea and A Brown and David Celermajer and Lisa Jamieson",
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    month = "11",
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    Kapellas, K, Mejia, GC, Bartold, PM, Skilton, M, Maple-Brown, L, Slade, G, O'Dea, K, Brown, A, Celermajer, D & Jamieson, L 2017, 'Periodontal therapy and glycaemic control among individuals with type 2 diabetes: reflections from the PerioCardio study', International Journal of Dental Hygiene, vol. 15, no. 4, pp. 42-51. https://doi.org/10.1111/idh.12234

    Periodontal therapy and glycaemic control among individuals with type 2 diabetes : reflections from the PerioCardio study. / Kapellas, Kostas; Mejia, Gloria C; Bartold, P. Mark; Skilton, Michael; Maple-Brown, Louise; Slade, Gary; O'Dea, Kerin; Brown, A; Celermajer, David; Jamieson, Lisa.

    In: International Journal of Dental Hygiene, Vol. 15, No. 4, 11.2017, p. 42-51.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Periodontal therapy and glycaemic control among individuals with type 2 diabetes

    T2 - reflections from the PerioCardio study

    AU - Kapellas, Kostas

    AU - Mejia, Gloria C

    AU - Bartold, P. Mark

    AU - Skilton, Michael

    AU - Maple-Brown, Louise

    AU - Slade, Gary

    AU - O'Dea, Kerin

    AU - Brown, A

    AU - Celermajer, David

    AU - Jamieson, Lisa

    PY - 2017/11

    Y1 - 2017/11

    N2 - Objectives: Diabetes mellitus and periodontal disease are highly prevalent among Indigenous Australian adults. Untreated periodontitis impacts glycaemic control in people with diabetes. The aim of this study was to report on the effect of periodontal therapy on glycaemic control among people with obesity.Methods: This subgroup analysis is limited to 62 participants with diabetes from the original 273 Aboriginal Australian adults enrolled into the PerioCardio study. Intervention participants received full-mouth non-surgical periodontal scaling during a single, untimed session while controls were untreated. Endpoints of interest included change in glycated haemoglobin (HbA1c), C-reactive protein (CRP) and periodontal status at 3 months post-intervention.Results: There were more females randomized to the treatment group (n = 17) than control (n = 10) while the control group had a higher overall body mass index (BMI) [mean (SD)] 33.1 (9.7 kg m−2) versus 29.9 (6.0 kg m−2). A greater proportion of males were followed up at 3 months compared to females, P = 0.05. Periodontal therapy did not significantly reduce HbA1c: ancova difference in means 0.22 mmol mol−1 (95% CI −6.25 to 6.69), CRP: ancova difference in means 0.64 (95% CI −1.08, 2.37) or periodontal status at 3 months.Conclusions: Non-surgical periodontal therapy did not significantly reduce glycated haemoglobin in participants with type 2 diabetes. Reasons are likely to be multifactorial and may be influenced by persistent periodontal inflammation at the follow-up appointments. Alternatively, the BMI of study participants may impact glycaemic control via alternative mechanisms involving the interplay between inflammation and adiposity meaning HbA1c may not be amenable to periodontal therapy in these individuals.

    AB - Objectives: Diabetes mellitus and periodontal disease are highly prevalent among Indigenous Australian adults. Untreated periodontitis impacts glycaemic control in people with diabetes. The aim of this study was to report on the effect of periodontal therapy on glycaemic control among people with obesity.Methods: This subgroup analysis is limited to 62 participants with diabetes from the original 273 Aboriginal Australian adults enrolled into the PerioCardio study. Intervention participants received full-mouth non-surgical periodontal scaling during a single, untimed session while controls were untreated. Endpoints of interest included change in glycated haemoglobin (HbA1c), C-reactive protein (CRP) and periodontal status at 3 months post-intervention.Results: There were more females randomized to the treatment group (n = 17) than control (n = 10) while the control group had a higher overall body mass index (BMI) [mean (SD)] 33.1 (9.7 kg m−2) versus 29.9 (6.0 kg m−2). A greater proportion of males were followed up at 3 months compared to females, P = 0.05. Periodontal therapy did not significantly reduce HbA1c: ancova difference in means 0.22 mmol mol−1 (95% CI −6.25 to 6.69), CRP: ancova difference in means 0.64 (95% CI −1.08, 2.37) or periodontal status at 3 months.Conclusions: Non-surgical periodontal therapy did not significantly reduce glycated haemoglobin in participants with type 2 diabetes. Reasons are likely to be multifactorial and may be influenced by persistent periodontal inflammation at the follow-up appointments. Alternatively, the BMI of study participants may impact glycaemic control via alternative mechanisms involving the interplay between inflammation and adiposity meaning HbA1c may not be amenable to periodontal therapy in these individuals.

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    U2 - 10.1111/idh.12234

    DO - 10.1111/idh.12234

    M3 - Article

    VL - 15

    SP - 42

    EP - 51

    JO - International Journal of Dental Hygiene

    JF - International Journal of Dental Hygiene

    SN - 1601-5029

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