Journal
DIABETES RESEARCH AND CLINICAL PRACTICE
Volume 100, Issue 1, Pages 53-60Publisher
ELSEVIER IRELAND LTD
DOI: 10.1016/j.diabres.2013.01.028
Keywords
Periodontitis; Low-grade inflammation; Glycated hemoglobin; Antibiotics
Categories
Funding
- 8020 Research fund from 8020 Promotion Foundation
- Japan Society for the Promotion of Science [21390556, 22390401]
- Grants-in-Aid for Scientific Research [22390401, 21390556] Funding Source: KAKEN
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Aims: Periodontal treatment reduces glycated hemoglobin (HbA1) in subjects with type 2 diabetes, although effective strategy for different severities of periodontitis remains unclear. We hypothesized that resolution of periodontitis-induced inflammation by the therapy combined with antibiotics may have beneficial effects on the glycemic control of diabetes. Methods: A total of 523 subjects with type 2 diabetes were screened for periodontal disease. Of these, 160 subjects who visited dentists were divided into two groups according to high-sensitivity c-reactive protein (hsCRP) level: > 500 ng/ml and < 500 ng/ml. The group with hsCRP over 500 ng/ml was further sub-divided into two groups according to treatment strategy: topical application of antibiotics combined with conventional mechanical debridement (group A), and debridement alone (B). Subjects with hsCRP below 500 ng/ml were subdivided similarly (C: combination therapy; D: debridement alone). hsCRP was measured after 1 month and changes of HbA1c after 3 months. These parameters were also measured in control subjects (N = 118) who did not visit dentists (E: initial hsCRP > 500 ng/ml; F: hsCRP < 500 ng/ml). Results: A multiple comparison by ANOVA revealed that only group A showed a significant reduction in HbA1c over time (P < 0.001). Multivariable analyses revealed elevated hsCRP and the combination treatment with antibiotics were two independent variables influencing the decrease of HbA1c over the study (P < 0.01 and P < 0.001, respectively). Conclusions: In subjects with type 2 diabetes and periodontitis-induced mild inflammation (hsCRP > 500 ng/ml), treatment to reduce hsCRP using antibiotics is recommended. (C) 2013 Elsevier Ireland Ltd. All rights reserved.
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