Evidence that periodontal treatment improves diabetes outcomes: a systematic review and meta‐analysis
- 30 April 2013
- journal article
- research article
- Published by Wiley in Journal of Clinical Periodontology
- Vol. 40 (s14), S153-S163
- https://doi.org/10.1111/jcpe.12084
Abstract
The effect of periodontal therapy on diabetes outcomes has not been established. This update examines the effect of periodontal treatment on diabetes outcomes. Literature since October 2009 using MEDLINE. Published RCTs including periodontal therapy for diabetic subjects, a metabolic outcome, an untreated control group, and follow-up of 3 months. Pre-defined data fields, including study quality indicators were used. A search revealed 56 publications of which 9 met inclusion criteria. Mean change of HbA1c from baseline was compared across treatment groups. Pooled analysis was based on random effects models. A meta-analysis indicated a mean treatment effect of -0.36% HbA1c (CI -0.54, -0.19) compared to no treatment after periodontal therapy (p < 0.0001). Heterogeneity tests revealed only minimal evidence of publication bias (I(2 ) = 9%). Small sample size and high risk of bias remain problematic for studies of this type. Periodontal therapy varied considerably. The modest reduction in HbA1c observed as a result of periodontal therapy in subjects with type 2 diabetes is consistent with previous systematic reviews. Despite this finding, there is limited confidence in the conclusion due to a lack of multi-centre trials of sufficient sample size are lacking.Keywords
Funding Information
- NIH/NIDCR (UO1 DE018902)
- GABA
- Federal Ministry of Education and Research
- Ministry of Cultural Affairs of the Federal State of Mecklenburg
- BMBF
This publication has 49 references indexed in Scilit:
- Sub-antimicrobial doxycycline for periodontitis reduces hemoglobin A1c in subjects with type 2 diabetes: A pilot studyPharmacological Research, 2011
- National, regional, and global trends in fasting plasma glucose and diabetes prevalence since 1980: systematic analysis of health examination surveys and epidemiological studies with 370 country-years and 2·7 million participantsThe Lancet, 2011
- Effect of Periodontal Treatment on Glycemic Control of Diabetic PatientsDiabetes Care, 2010
- The effect of periodontal therapy on the improvement of glycemic control in patients with type 2 diabetes mellitus: A randomized controlled clinical trialInternational Journal of Diabetes in Developing Countries, 2008
- Inflammation and insulin resistanceJCI Insight, 2006
- The effect of periodontal therapy on uncontrolled type 2 diabetes mellitus in older subjectsOral Diseases, 2005
- The effect of improved periodontal health on metabolic control in type 2 diabetes mellitusJournal of Clinical Periodontology, 2005
- Quantifying heterogeneity in a meta‐analysisStatistics in Medicine, 2002
- The Effect of a Thiazolidinedione Drug, Troglitazone, on Glycemia in Patients with Type 2 Diabetes Mellitus Poorly Controlled with Sulfonylurea and Metformin: A Multicenter, Randomized, Double-Blind, Placebo-Controlled TrialAnnals of Internal Medicine, 2001
- Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33)The Lancet, 1998