title: Periodontal therapy and glycaemic control among individuals with type 2 diabetes: reflections from the PerioCardio study.
abstract: OBJECTIVE
  Diabetes mellitus and periodontal disease are highly prevalent among Indigenous Australian adults. Untreated periodontitis impacts glycaemic control in people with diabetes. The aim of this study was to report on the effect of periodontal therapy on glycaemic control among people with obesity.
  
  
  METHODS
  This subgroup analysis is limited to 62 participants with diabetes from the original 273 Aboriginal Australian adults enrolled into the PerioCardio study. Intervention participants received full-mouth non-surgical periodontal scaling during a single, untimed session while controls were untreated. Endpoints of interest included change in glycated haemoglobin (HbA1c), C-reactive protein (CRP) and periodontal status at 3 months post-intervention.
  
  
  RESULTS
  There were more females randomized to the treatment group (n = 17) than control (n = 10) while the control group had a higher overall body mass index (BMI) [mean (SD)] 33.1 (9.7 kg m-2) versus 29.9 (6.0 kg m-2). A greater proportion of males were followed up at 3 months compared to females, P = 0.05. Periodontal therapy did not significantly reduce HbA1c: ancova difference in means 0.22 mmol mol-1(95% CI -6.25 to 6.69), CRP: ancova difference in means 0.64 (95% CI -1.08, 2.37) or periodontal status at 3 months.
  
  
  CONCLUSIONS
  Non-surgical periodontal therapy did not significantly reduce glycated haemoglobin in participants with type 2 diabetes. Reasons are likely to be multifactorial and may be influenced by persistent periodontal inflammation at the follow-up appointments. Alternatively, the BMI of study participants may impact glycaemic control via alternative mechanisms involving the interplay between inflammation and adiposity meaning HbA1c may not be amenable to periodontal therapy in these individuals.
authors.affiliation: Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, Adelaide, SA, Australia.|Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.
authors.forename: K
authors.identifier: http://orcid.org/0000-0002-3761-9953
authors.initials: K
authors.lastname: Kapellas
authors.affiliation: Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, Adelaide, SA, Australia.|School of Dental Medicine, East Carolina University, Greenville, NC, USA.
authors.forename: G
authors.initials: G
authors.lastname: Mejia
authors.affiliation: Colgate Australian Clinical Dental Research Centre, School of Dentistry, University of Adelaide, Adelaide, SA, Australia.
authors.forename: P M
authors.initials: PM
authors.lastname: Bartold
authors.affiliation: Boden Institute of Obesity, Nutrition, Exercise and Eating Disorders, University of Sydney, Sydney, NSW, Australia.
authors.forename: M R
authors.initials: MR
authors.lastname: Skilton
authors.affiliation: Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia.|Division of Medicine, Royal Darwin Hospital, Darwin, NT, Australia.
authors.forename: L J
authors.initials: LJ
authors.lastname: Maple-Brown
authors.affiliation: Department of Dental Ecology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: G D
authors.initials: GD
authors.lastname: Slade
authors.affiliation: Sansom Institute for Health Research, UniSA, Adelaide, SA, Australia.
authors.forename: K
authors.initials: K
authors.lastname: O'Dea
authors.affiliation: Aboriginal Research Unit, South Australian Health and Medical Research Institute, Adelaide, SA, Australia.
authors.forename: A
authors.initials: A
authors.lastname: Brown
authors.affiliation: Department of Medicine, University of Sydney, Sydney, NSW, Australia.
authors.forename: D S
authors.initials: DS
authors.lastname: Celermajer
authors.affiliation: Australian Research Centre for Population Oral Health, School of Dentistry, University of Adelaide, Adelaide, SA, Australia.
authors.forename: L M
authors.initials: LM
authors.lastname: Jamieson
mesh_terms: D001315:Australia / Q000453:epidemiology; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D002097:C-Reactive Protein / Q000032:analysis; D012534:Dental Scaling; D003924:Diabetes Mellitus, Type 2 / Q000097:blood* / Q000208:ethnology*; D005260:Female; D006442:Glycated Hemoglobin / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000208:ethnology*; D010510:Periodontal Diseases / Q000097:blood* / Q000517:prevention & control*; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein; D006442:Glycated Hemoglobin
keywords: Indigenous Australian; diabetes mellitus, type 2; periodontal therapy, non-surgical; randomized controlled trial