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Does Periodontal Treatment Improve Glycemic Control in Diabetic Patients? A Meta-analysis of Intervention Studies

¹ Department of General Dentistry, Boston University, Goldman School of Dental Medicine, 100 East Newton Street, Boston, MA 02118, USA;
² Harvard School of Public Health, Department of Nutrition, Boston, MA, USA;
³ US Air Force 59th Dental Squadron, San Antonio, TX, USA;
⁴ Stroke Neuroscience Unit, NINDS, National Institutes of Health, Bethesda, MD, USA;
⁵ Clinical Research Center/Periodontology and Oral Biology, Boston University Goldman School of Dental Medicine, Boston, MA, USA; and
⁶ VA Center for Health Quality, Outcomes and Economic Research, Bedford, MA, USA

^* corresponding author, sjanket{at}post.harvard.edu

Previous analyses regarding effects of periodontal treatment on glycemic control included studies where causal association might not be assumed, or the results were reported non-quantitatively. We initiated this meta-analysis of 10 intervention studies to quantify the effects of periodontal treatment on HbA1c level among diabetic patients, to explore possible causes for the discrepant reports, and to make recommendations for future studies. Data sources were MEDLINE (January, 1980, to January, 2005), the EBMR, Cochrane Register, and bibliographies of the published articles. Three investigators extracted data regarding intervention, outcomes, and effect size. A total of 456 patients was included in this analysis, with periodontal treatment as predictor and the actual change in hemoglobin A1c level as the outcome. The weighted average decrease in actual HbA1c level was 0.38% for all studies, 0.66% when restricted to type 2 diabetic patients, and 0.71% if antibiotics were given to them. However, none was statistically significant.

KEY WORDS: meta-analysis • inflammatory mediators • hemoglobin A1c • non-surgical periodontal treatment • antibiotics treatment

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