TY - JOUR
T1 - Effect of non-surgical periodontal therapy on insulin resistance and insulin sensitivity among individuals with borderline diabetes
T2 - A randomized controlled trial
AU - Nishioka, Shinji
AU - Maruyama, Koutatsu
AU - Tanigawa, Takeshi
AU - Miyoshi, Noriko
AU - Eguchi, Eri
AU - Nishida, Wataru
AU - Osawa, Haruhiko
AU - Saito, Isao
N1 - Funding Information:
We wish to thank the staff and participants of the Toon Health Study and the municipal authorities, officers, and health professionals of Toon city for their valuable contributions. This study was supported by Grants-in-Aid for Scientific Research from The Ministry of Education, Culture, Sports, Science and Technology of Japan , Grant/Award Number: Research B/22390134 , Research B/25293142 , 8020 Promotion Foundation and Meiji Yasuda Life Foundation of Health and Welfare .
Publisher Copyright:
© 2019 Elsevier Ltd
PY - 2019/6
Y1 - 2019/6
N2 - Objective: To investigate the effect of non-surgical periodontal therapy on insulin resistance and sensitivity among individuals with borderline diabetes not receiving medications. Methods: A crossover, randomized controlled trial was conducted among participants with borderline diabetes diagnosed by a 75-g oral glucose tolerance test. Participants were randomly assigned to either an early or later intervention group. The early intervention group underwent non-surgical periodontal therapy of scaling and root planing during the first 6 months, followed by a 6-month non-intervention period. The order was reversed in the later intervention group. Primary outcomes included: fasting or post-load serum glucose and insulin, body mass index (BMI), HOMA-IR, HOMA-β, and Matsuda Index. Results: Seventy-four participants were randomized, and 71 participants completed the trial. There were no significant differences between groups in glucose and insulin concentrations during the intervention and non-intervention periods. When analyzed within groups by median-split of bleeding on probing (BOP) levels before intervention, the lower BOP group showed improved changes in BMI, HOMA-IR, HOMA-β, and Matsuda Index (P < 0.05). Further, we observed a positive correlation between baseline BOP and change in BMI (P = 0.06). Change in BMI was positively correlated with changes in HbA1c, HOMA-IR, and HOMA-β (P < 0.05), and inversely correlated with change in Matsuda Index (P = 0.001). Conclusions: Periodontal therapy had no significant effect on markers related to insulin and glucose metabolism among individuals with borderline diabetes. However, participants with a lower BOP (%) showed significant improvements in BMI, fasting serum insulin, HOMA-IR, HOMA-β and Matsuda Index. Clinical significance: Among individuals diagnosed with borderline diabetes, those who had <37% of a lower BOP (%) showed potential improvements in BMI, fasting serum insulin, HOMA-IR, HOMA-β and Matsuda Index following non-surgical periodontal therapy.
AB - Objective: To investigate the effect of non-surgical periodontal therapy on insulin resistance and sensitivity among individuals with borderline diabetes not receiving medications. Methods: A crossover, randomized controlled trial was conducted among participants with borderline diabetes diagnosed by a 75-g oral glucose tolerance test. Participants were randomly assigned to either an early or later intervention group. The early intervention group underwent non-surgical periodontal therapy of scaling and root planing during the first 6 months, followed by a 6-month non-intervention period. The order was reversed in the later intervention group. Primary outcomes included: fasting or post-load serum glucose and insulin, body mass index (BMI), HOMA-IR, HOMA-β, and Matsuda Index. Results: Seventy-four participants were randomized, and 71 participants completed the trial. There were no significant differences between groups in glucose and insulin concentrations during the intervention and non-intervention periods. When analyzed within groups by median-split of bleeding on probing (BOP) levels before intervention, the lower BOP group showed improved changes in BMI, HOMA-IR, HOMA-β, and Matsuda Index (P < 0.05). Further, we observed a positive correlation between baseline BOP and change in BMI (P = 0.06). Change in BMI was positively correlated with changes in HbA1c, HOMA-IR, and HOMA-β (P < 0.05), and inversely correlated with change in Matsuda Index (P = 0.001). Conclusions: Periodontal therapy had no significant effect on markers related to insulin and glucose metabolism among individuals with borderline diabetes. However, participants with a lower BOP (%) showed significant improvements in BMI, fasting serum insulin, HOMA-IR, HOMA-β and Matsuda Index. Clinical significance: Among individuals diagnosed with borderline diabetes, those who had <37% of a lower BOP (%) showed potential improvements in BMI, fasting serum insulin, HOMA-IR, HOMA-β and Matsuda Index following non-surgical periodontal therapy.
KW - Borderline diabetes
KW - Insulin resistance and sensitivity
KW - Non-surgical periodontal therapy
KW - Periodontitis
KW - Randomized controlled trial
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U2 - 10.1016/j.jdent.2019.04.005
DO - 10.1016/j.jdent.2019.04.005
M3 - Article
C2 - 30986513
AN - SCOPUS:85065176092
VL - 85
SP - 18
EP - 24
JO - Journal of Dentistry
JF - Journal of Dentistry
SN - 0300-5712
ER -
