| 3236 Periodontal therapy and diabetes glycemic control | ||
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S.G. GROSSI1, F. SKREPCINSKI2, A. HO1, S. GARRETT3, W. ORTOLANO3, and R.J. GENCO1, 1SUNY at Buffalo, NY, USA, 2Indian Health Service, Albuquerque, NM, USA, 3Atrix Laboratories, Fort Collins, CO, USA Objective: To examine the effect of periodontal treatment on long-term glycemic control of diabetes. Methods: 75 Pueblo Indians with type 2 diabetes and severe periodontal disease were included in this randomized trial. Patients received ultrasonic debridement under continuous irrigation with 0.12% Chlorhexidine and one of the following regimes: a) single oral doxycycline 100 mg/bid, b) multiple oral doxycycline 100 mg/bid (baseline and 6 months); c) single oral doxycycline 100 mg/bid and multiple topical doxycycline (Atridox) every 3 months; d) multiple oral doxycycline 100 mg/bid and topical Atridox. Periodontal status and diabetes control were assessed at 3, 6, 9 and 12 months. Results: All 4 groups showed a significant reduction in percent sites with PD > 5 mm (P< 0.01) ranging from 17% to 27%. Patients with baseline > 9% glycated hemoglobin (HbA1c), i.e., uncontrolled diabetes, showed a reduction in this parameter ranging from 0.5 to 1.7% (P< 0.05). The greatest reduction in HbA1c levels was seen in the single oral doxycycline and multiple Atridox group. Levels of HbA1c in this group were reduced 1.1% at 1 month and 1.7% at 12 months (P< 0.01). A multiple regression model revealed that for every mm increment in mean pocket depth following periodontal therapy, HbA1c increased by 0.3 %, independent of the effect of age, gender and baseline level of HbA1c or pocket depth (P< 0.001). Our results demonstrate a significant reduction in levels of HbA1c in patients with uncontrolled diabetes following antiinfective periodontal therapy and that this reduction can be sustained for 12 months. Conclusions: Ultrasonic debridement combined with oral doxycycline and repeated topical doxycycline results in a long term reduction in levels of glycated hemoglobin. Therefore, regular antiinfective periodontal therapy in diabetics with periodontal disease is important for long-term glycemic control. Supported by DHHS Grant No. 282980004 and Atrix Laboratories. | ||
| Seq #300 - Emerging Concepts - Periodontal Epidemiology and Diagnosis 9:00 AM-11:00 AM, Saturday, 9 March 2002 San Diego Convention Center Room 6E (Upper level) | ||
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