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Randomized Controlled Trial
. 2018 Feb 26;18(1):28.
doi: 10.1186/s12903-018-0479-5.

Effects of nonsurgical periodontal treatment on glycated haemoglobin on type 2 diabetes patients (PARODIA 1 study): a randomized controlled trial in a sub-Saharan Africa population

Nadia-Flore Tsobgny-Tsague  1   2 , Eric Lontchi-Yimagou  3   4 , Arnel Redon Nana Nana  1   2 , Aurel T Tankeu  2   5 , Jean Claude Katte  4   6 , Mesmin Y Dehayem  2   5 , Charles Messanga Bengondo  1   7 , Eugene Sobngwi  8   9   10
Affiliations
Randomized Controlled Trial

Effects of nonsurgical periodontal treatment on glycated haemoglobin on type 2 diabetes patients (PARODIA 1 study): a randomized controlled trial in a sub-Saharan Africa population

Nadia-Flore Tsobgny-Tsague et al. BMC Oral Health. .

Abstract

Background: There is a burglar association between diabetes and periodontitis. Many studies has shown that periodontitis treatment can help improving glycemic control in diabetes patients but little evidence of non-surgical treatment benefit is available in sub Saharan african diabetes patients. We aimed to assess the effects of non-surgical periodontal treatment (NSPT) of chronic periodontitis on glycaemic control in poorly controlled type 2 diabetes patients (T2D) in a sub-Saharan Africa urban setting.

Methods: A total of 34 poorly controlled T2D patients with chronic periodontitis aged 51.4 ± 8.8 years (mean ± SD), with known duration of diabetes of 55.5 ± 42.6 months, and HbA1c of 9.3 ± 1.3% were randomly assigned to two groups. The treatment group (Group 1, n = 17) received immediate ultrasonic scaling, scaling and root planning along with subgingival 10% povidone iodine irrigation, whereas the control group (Group 2, n = 17) was assigned to receive delayed periodontal treatment 3 months later. Pharmacological treatment was unchanged and all participants received the same standardized education session on diabetes management and dental hygiene. The primary outcome was the 3-month change in HbA1c from baseline. Plaque index (PI), gingival bleeding index (GBI), pocket depth (PD), clinical attachment loss (CAL) were also assessed prior to, at 6 and 12 weeks after enrolment.

Results: Two subjects in each group were excluded from the study. Data were analyzed on thirty patients (15 per group). Non-surgical periodontal treatment with education for better dental hygiene (group 1) significantly improved all periodontal parameters whereas education only (group 2) improved only the plaque index among all periodontal parameters. Immediate non-surgical periodontal treatment induced a reduction of HbA1c levels by 3.0 ± 2.4 points from 9.7 ± 1.6% at baseline to 6.7 ± 2.0% 3 months after NSPT, (p ˂ 0.001) but the change was not significant in group 2, from mean 8.9 ± 0.9% at baseline vs 8.1 ± 2.6% after 3 months (p = 0.24).

Conclusion: Non-surgical periodontal treatment markedly improved glycaemic control with an attributable reduction of 2.2 points of HbA1c in poorly controlled T2D patients in a sub Saharan setting.

Trial registration: ClinicalTrials.gov Identifier: NCT02745015 Date of registration: July 17, 2016 'Retrospectively registered'.

Keywords: Diabetes; Glycemic control; HbA1c; Inflammation; Non-surgical periodontal treatment; Periodontitis.

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Conflict of interest statement

Ethics approval and consent to participate

This study was performed in accordance with the guidelines of the Helsinki Declaration and was approved by the Institutional Research Ethical Committee of the Faculty of Medicine and Biomedical Sciences of Yaoundé and by the institutional review board of the Yaoundé Central Hospital of Cameroon. All participants provided written informed consent.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Diagram showing the flow of participants through each stage of the trial
Fig. 2
Fig. 2
Changes in glycated haemoglobin during the follow up and between the two groups
See this image and copyright information in PMC

References

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