title: Effects of periodontal non-surgical therapy plus azithromycin on glycemic control in patients with diabetes: a randomized clinical trial.
abstract: OBJECTIVE
  Periodontitis may alter the systemic condition in patients with diabetes and hence interfere with glycemic control. The objective of this study was to determine the quantifiable changes in glycated hemoglobin (HbA1C) after periodontal non-surgical therapy plus azithromycin in a mixed population of patients with poorly controlled diabetes.
  
  
  METHODS
  One hundred and five patients were randomized to receive non-surgical therapy plus azythromycin (AZ-Sca =33), non-surgical therapy plus placebo (PB-Sca = 37) and supragingival prophylaxis plus azithromycin (AZ-Pro = 35). Glycated hemoglobin, glycemia and periodontal parameters were measured at baseline, 3, 6 and 9 mo after treatment.
  
  
  RESULTS
  Periodontal parameters were improved in the AZ-Sca and PB-Sca groups as compared to the AZ-Pro group. A greater reduction in probing depth was observed in the AZ-Sca as compared to the PB-Sca group. Improvement in clinical attachment level was similar between AZ-Sca and PB-Sca groups. A reduction from 8.0% to 7.2% (∆0.8%; p < 0.05) in HbA1C was observed in the AZ-Sca at 9 mo as compared to the PB-Sca group in which the reduction was from 7.9% to 7.6% (∆0.3%). There was no decrease in HbA1C in the AZ-Pro group over time. Mean glycemia values decreased from 195 mg/dL to 159.2 mg/dL (∆35.8 mg/dL; p < 0.05) in the AZ-Sca group whereas a decrease from 194 mg/dL to 174.8 mg/dL (∆19.2 mg/dL) in the PB-Sca group at 9 mo was observed. There were no differences between the AZ-Sca and PB-Sca groups for glycemic parameters. No improvement in glycemic values in the AZ-Pro group was observed.
  
  
  CONCLUSIONS
  A modest improvement in glycemic control was detected with a trend towards the use of non-surgical therapy plus AZ as compared to the placebo.
authors: Faculty of Dentistry, Universidad de Antioquia, Calle 64 52 - 59, Medellin, Antioquia, Colombia.
authors: J E
authors: JE
authors: Botero
authors: F L
authors: FL
authors: Yepes
authors: S P
authors: SP
authors: Ochoa
authors: J P
authors: JP
authors: Hincapie
authors: N
authors: N
authors: Roldan
authors: C A
authors: CA
authors: Ospina
authors: C A
authors: CA
authors: Castrillon
authors: M A
authors: MA
authors: Becerra
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D017963:Azithromycin / Q000627:therapeutic use*; D001786:Blood Glucose / Q000032:analysis*; D003131:Combined Modality Therapy; D003777:Dental Prophylaxis / Q000379:methods; D012534:Dental Scaling / Q000379:methods; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000517:prevention & control*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000517:prevention & control*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017622:Periodontal Attachment Loss / Q000628:therapy; D057747:Periodontal Debridement / Q000379:methods*; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000628:therapy; D010518:Periodontitis / Q000628:therapy; D010919:Placebos
chemical_list: D000900:Anti-Bacterial Agents; D017963:Azithromycin; D001786:Blood Glucose; D006442:Glycated Hemoglobin; D010919:Placebos
keywords: antibiotics; chronic periodontitis; diabetes; non-surgical periodontal therapy