The effect of antimicrobial periodontal treatment on circulating tumor necrosis factor-alpha and glycated hemoglobin level in patients with type 2 diabetes

Yoshihiro Iwamoto, Fusanori Nishimura, Masatsugu Nakagawa, Hikaru Sugimoto, Kenichi Shikata, Hirofumi Makino, Tetsuya Fukuda, Takao Tsuji, Masahiro Iwamoto, Yoji Murayama

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179 Citations (Scopus)


Background: Tumor necrosis factor-α (TNF-α) may play an important role in insulin resistance. In this study, we hypothesized that TNF-α produced due to periodontal inflammation synergistically affects insulin resistance as well as TNF-α produced from adipose tissues in insulin-resistant type 2 diabetes patients. Therefore, to understand the effects of antimicrobial periodontal therapy on serum TNF-α concentration and subsequent metabolic control of diabetes, we examined the periodontal and diabetic status on 13 type-2 diabetes patients. Methods: These patients were treated with local minocycline administration in every periodontal pocket around all existing teeth once a week for a month. Before and after treatment, the number of total bacteria in the periodontal pockets and circulating TNF-α concentration were measured and the HbA1c value was assessed. Results: Antimicrobial therapy significantly reduced the number of microorganisms in periodontal pockets (P <0.01). After treatment, the circulating TNF-α level was significantly reduced (P <0.015). The HbA1c value was also reduced significantly (P <0.007). In addition, the 6 patients who were not receiving insulin therapy demonstrated decreased fasting insulin levels (P <0.03), and HOMA-R (P <0.03) indices. The average reductions in circulating TNF-α concentration and HbA1c value were 0.49 pg/ml and 0.8%, respectively. Conclusion: The results indicate that anti-infectious treatment is effective in improving metabolic control in diabetics, possibly through reduced serum TNF-α and improved insulin resistance.

Original languageEnglish
Pages (from-to)774-778
Number of pages5
JournalJournal of periodontology
Issue number6
Publication statusPublished - Jun 1 2001
Externally publishedYes



  • Diabetes mellitus
  • Insulin resistance
  • Minocycline/therapeutic use
  • Non-insulin dependent/prevention and control
  • Obesity in diabetes
  • Periodontal diseases/therapy
  • Tumor necrosis factor

ASJC Scopus subject areas

  • Periodontics

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