Impact of periodontal disease on outcomes in diabetes

Contemp Clin Trials. 2015 Mar:41:93-9. doi: 10.1016/j.cct.2015.01.011. Epub 2015 Jan 24.

Abstract

Introduction: The prevalence of periodontal disease (POD) among adults aged 30years and older in the United States is reported to be more than 47%, with higher prevalence seen among patients with diabetes mellitus (DM). POD has been associated with systemic inflammation, a known risk factor for cardiovascular and bone disease, both of which are more common in patients with DM. However, there is mixed evidence that treatment of POD reduces inflammation, improves DM control, and reduces DM complications. Our study objectives are to assess factors associated with POD in patients with DM and determine the impact of POD treatment on inflammation and bone turnover biomarkers associated with complications of DM.

Methods: In this pilot study, we will first recruit 200 patients with DM to complete a 48-item investigator-administered questionnaire designed to assess socio-economic status, oral health status, adequacy of oral care, glycemic control and presence of DM complications. Responses will be verified by individual chart review. Then, using a crossover design, a subgroup of 24 subjects with responses suggestive of POD will be assigned to undergo POD treatment for three months followed by three months of routine dental care (group 1) or be followed for three months during routine dental care then receive POD treatment for three months (group 2). Outcome measures will be collected before and after POD treatment and include glycemic control and inflammatory and bone turnover biomarkers.

Results: We hypothesize that the prevalence of POD among DM patients will be associated with inadequate glycemic control and greater DM complications.

Keywords: Bone turnover biomarkers; Diabetes complications; Glycemic control; Inflammation biomarkers; Periodontal disease.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Alkaline Phosphatase / metabolism
  • Blood Glucose / metabolism
  • C-Reactive Protein / metabolism
  • Collagen Type I / urine
  • Cross-Over Studies
  • Cross-Sectional Studies
  • Diabetes Complications / metabolism
  • Diabetes Complications / therapy*
  • Diabetes Mellitus / metabolism
  • Diabetes Mellitus / therapy*
  • Glycated Hemoglobin / metabolism
  • Humans
  • Inflammation / metabolism
  • Peptides / urine
  • Periodontal Diseases / complications
  • Periodontal Diseases / metabolism
  • Periodontal Diseases / therapy*
  • Pilot Projects
  • Risk Factors
  • Tumor Necrosis Factor-alpha / metabolism

Substances

  • Blood Glucose
  • Collagen Type I
  • Glycated Hemoglobin A
  • Peptides
  • Tumor Necrosis Factor-alpha
  • collagen type I trimeric cross-linked peptide
  • hemoglobin A1c protein, human
  • C-Reactive Protein
  • Alkaline Phosphatase