title: Impact of periodontal disease on outcomes in diabetes.
abstract: BACKGROUND
  The prevalence of periodontal disease (POD) among adults aged 30years and older in the United States is reported to be more than 47%, with higher prevalence seen among patients with diabetes mellitus (DM). POD has been associated with systemic inflammation, a known risk factor for cardiovascular and bone disease, both of which are more common in patients with DM. However, there is mixed evidence that treatment of POD reduces inflammation, improves DM control, and reduces DM complications. Our study objectives are to assess factors associated with POD in patients with DM and determine the impact of POD treatment on inflammation and bone turnover biomarkers associated with complications of DM.
  
  
  METHODS
  In this pilot study, we will first recruit 200 patients with DM to complete a 48-item investigator-administered questionnaire designed to assess socio-economic status, oral health status, adequacy of oral care, glycemic control and presence of DM complications. Responses will be verified by individual chart review. Then, using a crossover design, a subgroup of 24 subjects with responses suggestive of POD will be assigned to undergo POD treatment for three months followed by three months of routine dental care (group 1) or be followed for three months during routine dental care then receive POD treatment for three months (group 2). Outcome measures will be collected before and after POD treatment and include glycemic control and inflammatory and bone turnover biomarkers.
  
  
  RESULTS
  We hypothesize that the prevalence of POD among DM patients will be associated with inadequate glycemic control and greater DM complications.
authors.affiliation: Internal Medicine, University of Nevada School of Medicine - Las Vegas, Administration Building, Suite 300, 2040 West Charleston Boulevard, Las Vegas, NV 89102, USA. Electronic address: kizuora@medicine.nevada.edu.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Izuora
authors.affiliation: Pediatrics, University of Nevada School of Medicine - Las Vegas, Administration Building, Suite 402, 2040West Charleston Boulevard, Las Vegas, NV 89102, USA. Electronic address: eezeanolue@medicine.nevada.edu.
authors.forename: Echezona
authors.initials: E
authors.lastname: Ezeanolue
authors.affiliation: Biochemistry and Molecular Biology, University of Nevada - Reno, Howard Medical Sciences Building, Suite 330, 1664 North Virginia Street, Reno, NV 89557, USA. Electronic address: schlauch@unr.edu.
authors.forename: Karen
authors.initials: K
authors.lastname: Schlauch
authors.affiliation: School of Dental Medicine, University of Nevada - Las Vegas, 1700 West Charleston Boulevard, Las Vegas, NV 89102, USA. Electronic address: michael.neubauer@unlv.edu.
authors.forename: Michael
authors.initials: M
authors.lastname: Neubauer
authors.affiliation: School of Dental Medicine, University of Nevada - Las Vegas, 1700 West Charleston Boulevard, Las Vegas, NV 89102, USA. Electronic address: civon.gewelber@sdm.unlv.edu.
authors.forename: Civon
authors.initials: C
authors.lastname: Gewelber
authors.affiliation: Endocrinology, Emory University School of Medicine, 100 Woodruff Circle, Atlanta, GA 30322, USA. Electronic address: geumpie@emory.edu.
authors.forename: Guillermo
authors.initials: G
authors.lastname: Umpierrez
mesh_terms: D000328:Adult; D000469:Alkaline Phosphatase / Q000378:metabolism; D001786:Blood Glucose / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D024042:Collagen Type I / Q000652:urine; D018592:Cross-Over Studies; D003430:Cross-Sectional Studies; D048909:Diabetes Complications / Q000378:metabolism / Q000628:therapy*; D003920:Diabetes Mellitus / Q000378:metabolism / Q000628:therapy*; D006442:Glycated Hemoglobin / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D010455:Peptides / Q000652:urine; D010510:Periodontal Diseases / Q000150:complications / Q000378:metabolism / Q000628:therapy*; D010865:Pilot Projects; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
chemical_list: D000469:Alkaline Phosphatase; D001786:Blood Glucose; D002097:C-Reactive Protein; D024042:Collagen Type I; D006442:Glycated Hemoglobin; D010455:Peptides; D014409:Tumor Necrosis Factor-alpha; C052929:collagen type I trimeric cross-linked peptide; C517652:hemoglobin A1c protein, human
keywords: Bone turnover biomarkers; Diabetes complications; Glycemic control; Inflammation biomarkers; Periodontal disease