Periodontal tissue susceptibility to glycaemic control in type 2 diabetes

Diabetes Obes Metab. 2024 Oct;26(10):4684-4693. doi: 10.1111/dom.15835. Epub 2024 Aug 14.

Abstract

Aim: To assess the direct effect of intensive glycaemic control on periodontal tissues in patients with diabetes mellitus.

Materials and methods: Twenty-nine patients with type 2 diabetes were enrolled and hospitalized to receive a 2-week intensive glycaemic control regimen. We observed and analysed the systemic and oral disease indicators before and after treatment and clarified the indicators related to periodontal inflammation.

Results: A significant reduction in glycaemic and periodontal parameters, including glycated albumin levels and periodontal inflamed surface area (PISA), was observed after treatment. The changes in PISA per tooth, indicative of periodontal healing, exhibited a bimodal distribution; the patients were divided into two groups on this basis. Correlations were observed between the changes in PISA per tooth and fasting plasma glucose, acetoacetic acid, and beta-hydroxybutyrate levels in the PISA-improved group. Significantly lower levels of C-peptide, coefficient of variation of R-R interval, and ankle-brachial pressure index were observed before treatment in the PISA non-improved group.

Conclusions: Glycaemic control treatment can effectively improve periodontitis in patients with type 2 diabetes, even in the absence of specific periodontal treatments. However, the periodontal responsiveness to glycaemic control treatment depends on the systemic condition of the patient.

Keywords: diabetes complications; glycaemic control; insulin secretion; type 2 diabetes.

MeSH terms

  • Aged
  • Ankle Brachial Index
  • Blood Glucose* / metabolism
  • C-Peptide / blood
  • Diabetes Mellitus, Type 2* / blood
  • Diabetes Mellitus, Type 2* / complications
  • Disease Susceptibility
  • Female
  • Glycated Hemoglobin / analysis
  • Glycated Hemoglobin / metabolism
  • Glycated Serum Albumin
  • Glycation End Products, Advanced
  • Glycemic Control*
  • Humans
  • Hypoglycemic Agents / therapeutic use
  • Male
  • Middle Aged
  • Periodontitis* / blood
  • Periodontitis* / complications
  • Periodontitis* / therapy
  • Serum Albumin / analysis

Substances

  • Blood Glucose
  • Glycated Hemoglobin
  • Hypoglycemic Agents
  • Glycation End Products, Advanced
  • Glycated Serum Albumin
  • Serum Albumin
  • C-Peptide