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Gum disease treatment could help to manage type 2 diabetes

Gum disease treatment could help to manage type 2 diabetes

Publication date: Wednesday, 28 November 2018

Treating periodontitis (gum disease) could help people with type 2 diabetes manage their blood glucose levels and may reduce the risk of diabetes-related complications, according to a new study published in the Lancet Diabetes and Endocrinology.

Researchers at the UCL Eastman Dental Institute recruited 264 people with Type 2 diabetes, all of whom had moderate to severe periodontitis. Half of the participants received intensive treatment for their gum disease, which involved deep cleaning their gums and minor gum surgery. The other half received standard care, involving regular cleaning and polishing of their teeth. The treatments were provided alongside any Type 2 diabetes medications being taken.

After 12 months, participants receiving the intensive treatment had reduced their blood glucose levels (HbA1c) by on average 0.6% more than the standard care group. This suggests that intensive gum disease treatment could help some people with Type 2 diabetes to improve their blood glucose levels.

Professor Francesco D’Aiuto, lead researcher of the study, said: “The improvement in blood glucose control we observed, in people who received intensive treatment, is similar to the effect that’s seen when people with Type 2 diabetes are prescribed a second blood glucose lowering drug. We now need to determine if the improvements we found can be maintained in the longer-term and if they apply to everyone with Type 2 diabetes.”

The findings are the first to link intensive gum disease treatment to improvements in kidney and blood vessel function and chronic inflammation. The researchers also observed a link between the treatment and improved quality of life.

  • Unadjusted mean HbA1c for the intensive periodontal treatment group was 7.8% compared to 8.3% for the standard treatment group.
  • With adjustment for baseline HbA 1c, age, sex, ethnicity, smoking status, duration of diabetes, and BMI, HbA 1c was 0·6% (95% CI 0·3–0·9; p<0·0001) lower in the intensive treatment group than in the standard treatment group.

Gum disease affects almost half of the UK population and people with diabetes have a higher risk of developing it. Gum disease sets in when the levels of bacteria inside the mouth are out of balance, and it causes chronic inflammation inside the body. This inflammation has been linked to cardiovascular and kidney complications, as well as insulin resistance.

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While more research is needed to explore this connection, the findings suggest that treatment may help to reduce the risk of serious diabetes-related complications, such as heart disease, stroke and kidney disease, in people with Type 2 diabetes. Currently people with Type 2 diabetes are not given oral health advice or treatment as part of their routine diabetes care.

D’Aiuto F et al. Systemic effects of periodontitis treatment in patients with type 2 diabetes: a 12 month, single-centre, investigator-masked, randomised trial. Lancet Diabetes and Endocrinology, published online 24 October   https://www.thelancet.com/pdfs/journals/landia/PIIS2213-8587(18)30038-X.pdf 

 

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Topics covered:
Category: Evidence in Practice
Edition: Volume 3 Number 11 PCCJ Online 2018

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