title: Influence of glycemic control on the levels of subgingival periodontal pathogens in patients with generalized chronic periodontitis and type 2 diabetes.
abstract: OBJECTIVE
  This study evaluated the influence of glycemic control on the levels and frequency of subgingival periodontal pathogens in patients with type 2 diabetes mellitus (DM) and generalized chronic periodontitis (ChP).
  
  
  METHODS
  Fifty-six patients with generalized ChP and type 2 DM were assigned according to the levels of glycated hemoglobin (HbA1c) into one of the following groups: HbA1c<8% (n=28) or HbA1c≥8% (n=28). Three subgingival biofilm samples from sites with probing depth (PD)<5 mm and three samples from sites with PD≥5 mm were analyzed by quantitative Polymerase Chain Reaction (PCR) for the presence and levels of Porphyromonas gingivalis, Tannerella forsythia, Treponema denticola, Eubacterium nodatum, Parvimona micra, Fusobacterium nucleatum ssp. and Prevotella intermedia.
  
  
  RESULTS
  The mean counts of F. nucleatum ssp. were statistically significantly higher in the sites with PD≥5 mm of the HbA1c≥8% group (p<0.05). Frequencies of detection of T. forsythia, E. nodatum, P. micra and F. nucleatum ssp. were all higher in the sites with PD≥5 mm of the patients with HbA1c≥8%, compared with those of patients with HbA1c<8% (p<0.05). Frequency of detection of P. intermedia was higher in the sites with PD<5 mm of the patients with HbA1c≥8% than those of the patients with HbA1c<8% (p<0.05).
  
  
  CONCLUSIONS
  Poor glycemic control, as indicated by HbA1c≥8%, is associated with increased levels and frequencies of periodontal pathogens in the subgingival biofilm of subjects with type 2 DM and ChP.
authors.affiliation: Universidade Guarulhos, Centro de Pós-Graduação e Pesquisa, Guarulhos, SP, Brasil.
authors.forename: Tamires Szeremeske
authors.initials: TS
authors.lastname: Miranda
authors.affiliation: Universidade Guarulhos, Centro de Pós-Graduação e Pesquisa, Guarulhos, SP, Brasil.
authors.forename: Magda
authors.initials: M
authors.lastname: Feres
authors.affiliation: Universidade Guarulhos, Centro de Pós-Graduação e Pesquisa, Guarulhos, SP, Brasil.
authors.forename: Belén
authors.initials: B
authors.lastname: Retamal-Valdés
authors.affiliation: Universidade Guarulhos, Centro de Pós-Graduação e Pesquisa, Guarulhos, SP, Brasil.
authors.forename: Paula Juliana
authors.initials: PJ
authors.lastname: Perez-Chaparro
authors.affiliation: Universidade Guarulhos, Centro de Pós-Graduação e Pesquisa, Guarulhos, SP, Brasil.
authors.forename: Suellen Silva
authors.initials: SS
authors.lastname: Maciel
authors.affiliation: Universidade Guarulhos, Centro de Pós-Graduação e Pesquisa, Guarulhos, SP, Brasil.
authors.forename: Poliana Mendes
authors.initials: PM
authors.lastname: Duarte
mesh_terms: D000328:Adult; D058491:Bacterial Load; D018441:Biofilms; D001786:Blood Glucose / Q000032:analysis*; D055113:Chronic Periodontitis / Q000097:blood* / Q000382:microbiology*; D015169:Colony Count, Microbial; D003773:Dental Plaque / Q000382:microbiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications / Q000382:microbiology* / Q000628:therapy*; D005260:Female; D005881:Gingiva / Q000382:microbiology*; D006090:Gram-Negative Bacteria / Q000302:isolation & purification; D006801:Humans; D006943:Hyperglycemia / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D060888:Real-Time Polymerase Chain Reaction; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
chemical_list: D001786:Blood Glucose