Effect of non-surgical periodontal therapy on insulin resistance and insulin sensitivity among individuals with borderline diabetes

A randomized controlled trial

Shinji Nishioka, Koutatsu Maruyama, Takeshi Tanigawa, Noriko Miyoshi, Eri Eguchi, Wataru Nishida, Haruhiko Osawa, Isao Saito

Research output: Contribution to journalArticle

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Abstract

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 HbA 1c , 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.

Original languageEnglish
JournalJournal of Dentistry
DOIs
Publication statusPublished - Jan 1 2019

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Insulin Resistance
Body Mass Index
Randomized Controlled Trials
Insulin
Hemorrhage
Fasting
Glucose
Therapeutics
Serum
Root Planing
Glucose Tolerance Test

Keywords

  • Borderline diabetes
  • Insulin resistance and sensitivity
  • Non-surgical periodontal therapy
  • Periodontitis
  • Randomized controlled trial

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Effect of non-surgical periodontal therapy on insulin resistance and insulin sensitivity among individuals with borderline diabetes : A randomized controlled trial. / Nishioka, Shinji; Maruyama, Koutatsu; Tanigawa, Takeshi; Miyoshi, Noriko; Eguchi, Eri; Nishida, Wataru; Osawa, Haruhiko; Saito, Isao.

In: Journal of Dentistry, 01.01.2019.

Research output: Contribution to journalArticle

Nishioka, Shinji ; Maruyama, Koutatsu ; Tanigawa, Takeshi ; Miyoshi, Noriko ; Eguchi, Eri ; Nishida, Wataru ; Osawa, Haruhiko ; Saito, Isao. / Effect of non-surgical periodontal therapy on insulin resistance and insulin sensitivity among individuals with borderline diabetes : A randomized controlled trial. In: Journal of Dentistry. 2019.
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AU - Nishioka, Shinji

AU - Maruyama, Koutatsu

AU - Tanigawa, Takeshi

AU - Miyoshi, Noriko

AU - Eguchi, Eri

AU - Nishida, Wataru

AU - Osawa, Haruhiko

AU - Saito, Isao

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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 HbA 1c , 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 HbA 1c , 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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