Does periodontal care improve glycemic control? The Department of Veterans Affairs Dental Diabetes Study.
OBJECTIVE
Report results of a randomized-clinical trial of the efficacy of periodontal care in the improvement of glycemic control in 165 veterans with poorly controlled diabetes over 4 months.


METHODS
Outcomes were change in Haemoglobin A1c (HbA1c) in the Early Treatment versus untreated (Usual Care) groups and percent of participants with decreases in HbA1c. Analyses included simple/multiple variable linear/logistic regressions, adjusted for baseline HbA1c, age, and duration of diabetes.


RESULTS
Unadjusted analyses showed no differences between groups. After adjustment for baseline HbA1c, age, and diabetes duration, the mean absolute HbA1c change in the Early Treatment group was -0.65% versus -0.51% in the Usual Care group (p=0.47). Adjusted odds for improvement by 0.5% in the Early Treatment group was 1.67 (95% confidence interval: 0.84, 3.34, p=0.14). Usual Care subjects were twice as likely to increase insulin from baseline to 4 months (20% versus 11%, p=0.12) and less likely to decrease insulin (1% versus 6%, p=0.21) than Early Treatment subjects. Among insulin users at baseline, more increased insulin in the Usual Care group (40% versus 21%, p=0.06).


CONCLUSIONS
No significant benefit was found for periodontal therapy after 4 months in this study; trends in some results were in favour of periodontal treatment.
Jones
Judith A
JA
VA Center for Health Quality, Outcomes and Economic Research, Bedford, MA, USA. judjones@bu.edu
Miller
Donald R
DR
Wehler
Carolyn J
CJ
Rich
Sharron E
SE
Krall-Kaye
Elizabeth A
EA
McCoy
Linda C
LC
Christiansen
Cindy L
CL
Rothendler
James A
JA
Garcia
Raul I
RI
D000367:Age Factors; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D001786:Blood Glucose / Q000032:analysis; D002710:Chlorhexidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D012534:Dental Scaling; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000517:prevention & control; D004318:Doxycycline / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010510:Periodontal Diseases / Q000628:therapy*; D016745:Root Planing; D013997:Time Factors; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D000891:Anti-Infective Agents, Local; D001786:Blood Glucose; D002710:Chlorhexidine; D004318:Doxycycline; D006442:Glycated Hemoglobin; D007004:Hypoglycemic Agents; D007328:Insulin; C010882:chlorhexidine gluconate