Effect of non-surgical periodontal therapy on insulin resistance in patients with type II diabetes mellitus and chronic periodontitis, as assessed by C-peptide and the Homeostasis Assessment Index.
OBJECTIVE
A bidirectional relationship exists between diabetes and periodontitis. In the present clinical trial, we evaluated the effects of non-surgical periodontal therapy (NSPT) on insulin resistance in patients with type II diabetes mellitus (DM) and chronic periodontitis.


METHODS
Forty chronic periodontitis patients with type II DM were selected and equally allocated to case and control groups. All patients were assessed for periodontal parameters and systemic parameters. The case group received NSPT, and both groups were re-evaluated after 3 months.


RESULTS
All periodontal parameters were found to be significantly improved in the case group compared to the control group 3 months after NSPT. The mean differences in systemic parameters, such as fasting serum C-peptide, Homeostasis Assessment (HOMA) Index-insulin resistance, and HOMA-insulin sensitivity, from baseline to 3 months for the case group were 0.544 ± 0.73, 0.54 ± 0.63, and -25.44 ± 36.81, respectively; for the control group, they were significant at -1.66 ± 1.89, -1.48 ± 1.86, and 31.42 ± 38.82 respectively (P < 0.05). There was a significant decrease in fasting blood glucose and glycosylated hemoglobin A1c from baseline to 3 months in the case group (P < 0.05).


CONCLUSIONS
The present study showed that periodontal inflammation could affect glycemic control and insulin resistance. Effective periodontal therapy reduced insulin resistance and improved periodontal health status and insulin sensitivity in patients with type II DM and chronic periodontitis.
Department of Periodontics, Government Dental College, Calicut, Kerala, India.
Jerry
J
Mammen
Department of Periodontics, Government Dental College, Calicut, Kerala, India.
Rosamma Joseph
RJ
Vadakkekuttical
Department of Periodontics, Government Dental College, Calicut, Kerala, India.
Joseraj Manaloor
JM
George
Department of Periodontics, Government Dental College, Calicut, Kerala, India.
Jaishid Ahadal
JA
Kaziyarakath
Department of Periodontics, Government Dental College, Calicut, Kerala, India.
Chandni
C
Radhakrishnan
D002096:C-Peptide / Q000097:blood; D055113:Chronic Periodontitis / Q000097:blood / Q000378:metabolism* / Q000628:therapy*; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000378:metabolism*; D006706:Homeostasis; D006801:Humans; D007333:Insulin Resistance
D002096:C-Peptide
C-peptide; Homeostasis Assessment Index; chronic periodontitis; insulin resistance; type II diabetes mellitus