Systemic effects of periodontitis treatment in patients with type 2 diabetes: a 12 month, single-centre, investigator-masked, randomised trial.
(The Lancet – Diabetes & Endocrinology; doi: 10.1016/S2213-8587(19)30036-1)
Francesco D’Aiuto, Nikolaos Gkranias, Devina Bhowruth, Tauseef Khan, Marco Orlandi, Jean Suvan, Stefano Masi, Georgios Tsakos, Steve Hurel, Aroon D Hingorani, Nikos Donos, John E Deanfield, TASTE Group
Inflammation from gum disease may be relevant to diabetes management. This trial tested whether a more intensive programme of gum treatment could improve blood glucose over a full year.
Researchers randomly assigned 264 people with type 2 diabetes and moderate-to-severe periodontitis to intensive gum treatment or a comparison programme.
Intensive care included cleaning below the gumline, further treatment when needed and follow-up. The comparison group received cleaning above the gums.
At twelve months, HbA1c was about 0.6 percentage points lower with intensive treatment than with comparison care. HbA1c reflects average blood glucose over the previous few months.
Gum health also improved.
Researchers reported changes in inflammation and measurements related to blood vessel and kidney function, but these measurements are not the same as showing fewer heart attacks or cases of kidney failure.
The trial supports including appropriate gum treatment in care for people with both type 2 diabetes and periodontitis.
It does not mean everyone needs the same intensive treatment or will experience the same glucose improvement.
The results apply most directly to people resembling the participants, rather than to everyone with diabetes or mild gum bleeding. Your dental team can explain the treatment needed for your own gum condition.
The most useful comparison is the difference between the treatment groups, rather than improvement within just one group.
Results also depend on who took part, the comparison care and how long people were followed.
A statistically uncertain difference does not prove two approaches are identical. Equally, a clear difference in a measurement may not show a lasting benefit for tooth retention or general health.
These findings need to be considered alongside other trials and your individual clinical needs when discussing treatment choices.
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Periodontitis is the 6th most prevalent condition globally
Periodontitis and diabetes are bidirectionally linked
Diabetic complications are increased if you have both diseases
Successful periodontal treatment can improve blood glucose control
Periodontitis is the 6th most prevalent condition globally
Periodontitis and diabetes are bidirectionally linked
Diabetic complications are increased if you have both diseases
Successful periodontal treatment can improve blood glucose control
