scholarly journals Outcomes of Periodontal Treatment in Diabetes Mellitus Patients at Kiruddu Referral Hospital in Uganda. A Prospective Cohort Study

2021 ◽  
Author(s):  
Haruna Kiryowa ◽  
Erisa Mwaka ◽  
William Buwembo ◽  
Ian Munabi ◽  
Charles Rwenyonyi ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Cohort Study ◽  
Glycemic Control ◽  
Periodontal Disease ◽  
Gingival Crevicular Fluid ◽  
Fusobacterium Nucleatum ◽  
Periodontal Treatment ◽  
Diabetic Patients ◽  
Clinical Attachment Loss ◽  
Mean Differences

Abstract Introduction: Periodontitis is a common complication of diabetes mellitus associated with poor glycemic control. The relationship between periodontal disease and glycemic control in patients with diabetes mellitus remains unclear. This study set out to determine the outcomes of periodontal treatment in diabetic patients in Uganda. Methods: Using a cohort study design, 41 adult diabetic patients with periodontal disease were enrolled and followed up for 3 months. Fasting blood sugar, glycated hemoglobin levels, pocketprobing depth, bleeding and clinical attachment loss at baseline and 3 months after periodontal treatment were determined. Gingival crevicular fluid was assessed to detect presence of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Bacteroides forsythus and Fusobacterium nucleatum. Data were analyzed using R version 4.10. Mean differences were calculated to determine effect of treatment and multiple logistic regressions was used to determine association between Hba1c and the different variables.Results: Of the41 participants, 61% were females while 39% were males. The average age was 49.2 years (S.D = 11.2)while the mean BM1 was 27.8 (S.D = 4.8). Overall, there was a reduction in the average number of teeth with bleeding sites, those with pockets and the frequencies of selected bacteria except Fusobacterium nucleatum at 3 months after periodontal treatment. Following periodontal treatment, 39% of the participants had an improvement in their glycemic control (mean HbA1c reduction of 1.86) with age < 47.1 years, diabetic duration less than 1.6 years, BM1< 27.7 and HBA1c >8.9 at baseline being positively associated with this improvement. Conclusion: Treating periodontal disease in diabetic patients especially those with HBA1c <9.0 can improve glycemic control. However, larger studies need to be conducted to ascertain why some patients fail to attain an improved metabolic control following this intervention.

scholarly journals Glycemic control and the production of cytokines in diabetic patients with chronic periodontal disease

2017 ◽  
Vol 65 (1) ◽  
pp. 37-43
Author(s):  
Mayra Moura FRANCO ◽  
Mariana Mader Miranda MORAES ◽  
Poliana Mendes DUARTE ◽  
Marcelo Henrique NAPIMOGA ◽  
Bruno Braga BENATTI
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Periodontal Disease ◽  
Chronic Periodontitis ◽  
Diabetic Patients ◽  
Chronic Periodontal Disease ◽  
Group D

ABSTRACT Objective: To evaluate the association of glycemic control and cytokine production in type 2 diabetic subjects with chronic periodontitis Methods: Gingival biopsies were performed in 40 patients, divided into four groups: systemically healthy subjects without periodontal disease (S); systemically healthy patients with chronic periodontitis (P); patients with well-controlled type 2 diabetes mellitus (DM) with chronic periodontitis (C); poorly controlled type 2 diabetes mellitus with chronic periodontitis (D). The production of interleukin (IL) -4, -6, -10, -17 and interferon (IFN) -γ was quantified by ELISA. Results: The production of IL-4, IL-10, IL-17 and INF-γ was higher on group D when compared to other groups (p <0.05), which in turn were similar (p ≥0.05). In addition, there was no difference in the production of IL-6 in any of the evaluated groups (p≥0.05). Conclusion: Were observed significantly elevated levels of pro-inflammatory and anti-inflammatory cytokines in patients with poorly controlled type 2 diabetes and chronic periodontitis, demonstrating that glycemic control may be associated to the immune inflammatory response of sites with chronic periodontitis.

scholarly journals BETA GLUCURONIDASE ACTIVITY IN DIABETES ASSOCIATED PERIODONTITIS

2020 ◽  
Vol 8 (9) ◽  
pp. 1222-1230
Author(s):  
Gawali S ◽  
◽  
Padhye A ◽  
Chavan P ◽  
◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Enzyme Activity ◽  
Periodontal Disease ◽  
Gingival Crevicular Fluid ◽  
Diabetic Patients ◽  
Tissue Destruction ◽  
Pocket Depth ◽  
Glucuronidase Activity ◽  
Probing Pocket Depth ◽  
Crevicular Fluid

Diabetes mellitus is a risk factor for development of periodontal disease with progressive periodontal destruction seen in diabetic patients. Advances in oral and periodontal disease diagnostic research are moving towards methods whereby periodontal risk can be identified and quantified by objective measures such as biomarkers. The aim of this study was to identify the presence of beta glucuronidase activity as an enzymatic biomarker of periodontal tissue destruction in patients of Diabetes mellitus associated with Periodontitis. β Glucuronidase activitywas estimated in saliva, GCF (Gingival Crevicular Fluid) and serum in healthy subjects and patients with Diabetes mellitus, Periodontitis and Diabetes associated periodontitis. Enzyme activity was compared with clinical parameters like Probing pocket depth, Plaque Index and Gingival Index. It was maximally raised in diabetic cases with periodontitis. Enzyme activity was found to be highest in crevicular fluid compared to saliva and serum. However, serum Glucuronidase correlated significantly with clinical indices. β-glucuronidase may be employed on routine basis as a chair side test for screening and diagnosis of patients with periodontitis in diabetics.

scholarly journals Study on the Effects of Melatonin on Glycemic Control and Periodontal Parameters in Patients with Type II Diabetes Mellitus and Periodontal Disease

Medicina ◽  
2021 ◽  
Vol 57 (2) ◽  
pp. 140
Author(s):  
Diana-Maria Anton ◽  
Maria-Alexandra Martu ◽  
Marius Maris ◽  
George-Alexandru Maftei ◽  
Irina-Georgeta Sufaru ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Periodontal Disease ◽  
Glycated Hemoglobin ◽  
Systemic Treatment ◽  
Periodontal Treatment ◽  
Scaling And Root Planing ◽  
Root Planing ◽  
Patients With Diabetes

Background and Objectives: There is evidence that melatonin could improve the periodontal status and also glycemic control of patients with diabetes mellitus. Therefore, the aim of this study was to assess the effects of scaling and root planing plus adjunctive systemic treatment with melatonin on periodontal parameters and glycemic control in patients with type 2 diabetes and chronic periodontitis. Materials and Methods: The study was conducted on 54 subjects with periodontitis and diabetes mellitus randomly assigned to the study group (n = 27, subjects with scaling and root planing + melatonin) or control group (n = 27, subjects with scaling and root planing + placebo). Periodontal parameters (probing depth—PD; clinical attachment loss—CAL; bleeding on probing—BOP; and hygiene level) and glycated hemoglobin (HbA1c) were assessed at baseline and 8 weeks after. Results: At baseline, there were no significant differences between groups, but at the second evaluation 8 weeks later the association of melatonin with the non-surgical periodontal therapy exerted statistically significant improvements, both in periodontal parameters, with a significant decrease in periodontal disease severity, and glycated hemoglobin when compared to the control subjects. Conclusions: In our study, combined non-surgical periodontal treatment and systemic treatment with melatonin provided additional improvements to severe periodontal condition and the glycemic control of patients with diabetes type 2 when compared to non-surgical periodontal treatment alone.

scholarly journals Glycemic control and the production of cytokines in diabetic patients with chronic periodontal disease

2015 ◽  
Vol 63 (4) ◽  
pp. 432-438 ◽  
Author(s):  
Mayra Moura FRANCO ◽  
Mariana Mader Miranda MORAES ◽  
Poliana Mendes DUARTE ◽  
Marcelo Henrique NAPIMOGA ◽  
Bruno Braga BENATTI
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Glycemic Control ◽  
Periodontal Disease ◽  
Chronic Periodontitis ◽  
Diabetic Patients ◽  
Chronic Periodontal Disease ◽  
Group D

Objective: To evaluate the association of glycemic control and cytokine production in type 2 diabetic subjects with chronic periodontitis. Methods: Gingival biopsies were performed in 40 patients, divided into four groups: systemically healthy subjects without periodontal disease (S); systemically healthy patients with chronic periodontitis (P); patients with well-controlled type 2 diabetes mellitus (DM) with chronic periodontitis (C); poorly controlled type 2 diabetes mellitus with chronic periodontitis (D). The production of interleukin (IL) -4, -6, -10, -17 and interferon (IFN) -g was quantified by ELISA. Results: The production of IL-4, IL-10, IL-17 and INF-g was higher on group D when compared to other groups (p <0.05), which in turn were similar (p ³0.05). In addition, there was no difference in the production of IL-6 in any of the evaluated groups (p³0.05). Conclusion: Were observed significantly elevated levels of pro-inflammatory and anti-inflammatory cytokines in patients with poorly controlled type 2 diabetes and chronic periodontitis, demonstrating that glycemic control may be associated to the immune inflammatory response of sites with chronic periodontitis.

scholarly journals Proinflammatory and Antimicrobial Nitric Oxide in Gingival Fluid of Diabetic Patients with Periodontal Disease

2006 ◽  
Vol 74 (12) ◽  
pp. 7010-7013 ◽  
Author(s):  
Uros Skaleric ◽  
Boris Gaspirc ◽  
Nancy McCartney-Francis ◽  
Andrej Masera ◽  
Sharon M. Wahl
Keyword(s):  
Nitric Oxide ◽  
Diabetes Mellitus ◽  
Periodontal Disease ◽  
Gingival Crevicular Fluid ◽  
No Synthase ◽  
Diabetic Patients ◽  
Prevotella Intermedia ◽  
Dual Roles ◽  
Crevicular Fluid ◽  
Gingival Fluid

ABSTRACT Abnormal nitric oxide (NO) synthesis has been implicated in the pathogenesis of both periodontal disease and diabetes mellitus. In diabetic patients, increased inducible NO synthase in inflamed gingiva correlated with NO in gingival crevicular fluid. Although increased NO reflected more-severe inflammation, it was associated with reductions in CFU of Prevotella intermedia, a major periodontopathogen, highlighting dual roles for NO.

Effects of periodontal therapy with topical antibiotics in the glycemic control of diabetic patients: systematic review.

2019 ◽  
Vol 27 (1) ◽  
pp. 31-42
Author(s):  
Gloria Cristina Aranzazu-Moya
Keyword(s):  
Periodontal Disease ◽  
Periodontal Therapy ◽  
Periodontal Treatment ◽  
Diabetic Patients ◽  
Inclusion Criteria ◽  
Topical Antibiotics ◽  
Bias Risk ◽  
Black Scale ◽  
Glycated Hemoglobin A ◽  
Modest Reduction

Background: Periodontal disease is considered as a diabetes complication and has been suggested that periodontal treatment plus antibiotics should reduce glycated hemoglobin A, by reducing local production of pro inflammatory substances. Objective: To evaluate diabetic patients with periodontal disease under periodontal treatment plus topical antibiotics and reduction of  HbA1c, compared to diabetic patients under periodontal treatment without antibiotics. Materials and Methods: Using PUBMED, SCOPUS, WEB OF SCIENCE, EMBASE and Google Scholar data bases, were screened documents from 2008 to 2018. The documents included were the clinical studies, which included non-surgical periodontal treatment plus topical antibiotics, whose outcomes included the HbA1c report. Two independent researchers evaluate title; abstract and bias risk with Downs Black scale and Cochrane tool. Documents with a score higher than 15 on average by the two evaluators were included. Results: Five articles, which find inclusion criteria, were identified. Two documents failed to demonstrate statistically significant effect when compared to non-surgical periodontal therapy alone. Conclusion: In general a modest reduction of HbA1c was identified when using antibiotic therapy.

scholarly journals A preliminary study on diabetes self-management education and glycemic control among patients with diabetes mellitus

2019 ◽  
Vol 9 (9) ◽  
pp. 98 ◽  
Author(s):  
Kisokanth G. ◽  
Indrakumar J. ◽  
Prathapan S. ◽  
Joseph J. ◽  
Ilankoon I.M.P.S.
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Management Education ◽  
Self Management ◽  
Rank Test ◽  
Diabetic Patients ◽  
Effective Measure ◽  
Before And After ◽  
Patients With Diabetes ◽  
Preliminary Study

This study was aimed to assess the effectiveness of diabetes self-management education (DSME) in the improvement of glycemic control among patients with type 2 Diabetes Mellitus (T2DM) in Batticaloa District, Sri Lanka. The study was a prospective interventional study and conducted as a preliminary study at medical clinic, Base hospital, Kaluwanchikudy, Batticaloa. Thirty patients with T2DM were included based on inclusion and exclusion criteria. A structured individual diabetes self-management education for 10 hours (one hour per week) was delivered to diabetic patients by the trained Nurse Health Educator. Glycosylate hemoglobin (HbA1c) was assessed as a main outcome measure and Fasting Blood Sugar (FBS), Body Mass Index (BMI) of each patient were also measured and recorded before and after the intervention. The respondent rate was 96.7% (n = 29). Majority of them were females (n = 25, 86.2%). A Wilcoxon signed rank test showed that DSME had a statistically significant reduction in HbA1c [8.60 (IQR 2.60) vs. 7.40 (IQR 2.10), p = .000] and FBS level [159.00 (IQR 77.50) vs. 134.00 (IQR 40.50), p = .002] at 3 months of intervention. The mean BMI at baseline was higher compared to 3 months of intervention [24.88 (SD ± 3.06) vs. 24.19 (SD ± 2.79)] which was statistically significant (p = .000). Majority of participants (n = 22, 75.9%) had improved their HbA1c level by ≥ 0.5% in 3 months. The diabetes self-management education is an effective measure in improving glycemic control and other clinical parameters among patients with T2DM. Thus, DSME needs to be implemented among clinic patients with T2DM for the better outcome and the preventions of complications.

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