CHANGE OF HEMOGLOBIN A1C, FASTING PLASMA GLUCOSE AND HS-CRP LEVELS AFTER ONE VISIT SUBGINGIVAL ULTRASONIC DEBRIDEMENT WITH ADJUNCTIVE MINOCYCLINE GEL IN TYPE II- DIABETES PERIODONTITIS PATIENTS
Keywords:
Periodontal classification 2018, Periodontitis treatment, minocycline gel, HbA1cAbstract
Objective: To evaluate the level of HbA1c (hemoglobin A1C), FPG (fasting plasma glucose) and hs-CRP (high sensitivity C-reactive protein) changes by the effect of one-visit subgingival ultrasonic debridement with adjunctive minocycline gel in type II diabetes-periodontitis patients. Materials and methods: 60 patients were diagnosed as periodontitis according to 2018 classification with type II diabetes and randomly devided into test or control groups. The test groups were received one-visit subgingival ultrasonic debridement with adjunctive minocycline gel (n=30) at baseline and 3 months while the control groups were received one-visit subgingival ultrasonic debridement only (n=30) at baseline and 3 months. Blood sampling was performed at the baseline, three and six months after treatment. HbA1c, FPG and hs-CRP level were analyzed. Results: 58 patients remained in the final analysis. In subjects with poorly controlled diabetes (HbA1c>8%), HbA1c level in the test groups were significantly decreased compared to the control group after three months of treatment. Moreover, the hs-CRP level in the test groups were significantly decreased compared to the control group after six months of treatment. Conclusions: One-visit subgingival ultrasonic debridement with adjunctive minocycline gel in poorly controlled type II diabetes patients could reduce HbA1c and hs-CRP level more than one-visit subgingival ultrasonic debridement only.
Downloads
References
American Diabetes Association. (2005). Diagnosis and classification of diabetes mellitus. Diabetes Care, 28(1), 37-42.
Socransky SS, Haffajee AD. (1992). The bacterial etiology of destructive periodontal disease: current concepts. J Periodontol, 63, 322-331.
Jepsen S, Caton JG, Albandar JM, Bissada NF, Bouchard P, Cortellini P, Demirel K, Sanctis M. (2018). Periodontal manifestations of systemic diseases and developmental and acquired conditions: Consensus report of workgroup 3 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions. J Clin Periodontol, 45, 219-229.
Khader YS, Dauod AS, El-Qaderi SS, Alkafajei A, Batayha WQ. (2006). Periodontal status of diabetics compared with nondiabetics: a meta-analysis. J Diabetes Complicat, 20(1), 59-68.
Tsai C, Hayes C, Taylor GW. (2002). Glycemic control of type 2 diabetes and severe periodontal disease in the US adult population. Community dent oral epidemiol, 30(3), 182-192.
Lalla E, Papapanou PN. (2011). Diabetes mellitus and periodontitis: a tale of two common interrelated diseases. Nat Rev Endocrinol, 7(12), 738-748.
Loos, B. G. (2005). Systemic markers of inflammation in periodontitis. J Periodontol, 76, 2106-2115.
Uysal KT, Wiesbrock SM, Marino MW, Hotamisligil GS. (1997). Protection from obesity-induced insulin resistance in mice lacking TNF-alpha function. Nature, 389(6651), 610-614.
Klover PJ, Zimmers TA, Koniaris LG, Mooney RA. (2003). Chronic exposure to interleukin-6 causes hepatic insulin resistance in mice. Diabetes, 52(11), 2784-2789.
Hotamisligil GS. (2000). Molecular mechanisms of insulin resistance and the role of the adipocyte. Int J Obes (Lond), 24(S4), S23.
Serino G, Rosling B, Ramberg P, Socransky SS, Lindhe J. (2001). Initial outcome and long‐term effect of surgical and non‐surgical treatment of advanced periodontal disease. J Clin Periodontol, 28(10), 910-916.
Damrongkosit S. (2013). Effect of one visit root debridement on clinical changes and haemoglobin A1c in periodontitis-diabetes mellitus type II patients. Masterthesis, M.S. (Periodontology). Bangkok: Srinakharinwirot University.
Abbas S, Mahendra J, Ari G. (2016). Minocycline ointment as a local drug delivery in the treatment of generalized chronic Periodontitis-a clinical study. J Clin Diagnostic Res, 10(6), 15-19.
Holmes SG, Still K, Buttle DJ, Bishop NJ, Grabowski PS. (2004). Chemically modified tetracyclines act through multiple mechanisms directly on osteoclast precursors. Bone, 35(2), 471-478.
Bahrami F, L Morris D, H Pourgholami M. (2012). Tetracyclines: drugs with huge therapeutic potential. Mini Rev Med Chem, 12(1), 44-52.
Stratton IM, Adler AI, Neil HA, Matthews DR, Manley SE, Cull CA, Hadden D. Turner RC. (2000). Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): prospective observational study. Bmj, 321(7258), 405-412.
Matsumoto S, Ogawa H, Soda S, Hirayama S, Amarasena N, Aizawa Y, Miyazaki H. (2009). Effect of antimicrobial periodontal treatment and maintenance on serum adiponectin in type 2 diabetes mellitus. J Clin Periodontol, 36(2), 142-148.
Katagiri S, Nitta H, Nagasawa T, Uchimura I, Izumiyama H, Inagaki K, Kikuchi T, Noguchi T. (2009). Multi-center intervention study on glycohemoglobin (HbA1c) and serum, high-sensitivity CRP (hs-CRP) after local anti-infectious periodontal treatment in type 2 diabetic patients with periodontal disease. Diabetes Res Clin Pract, 83(3), 308-315.
Munenaga Y, Yamashina T, Tanaka J, Nishimura F, Hiroshima Study Group. (2013). Improvement of glycated hemoglobin in Japanese subjects with type 2 diabetes by resolution of periodontal inflammation using adjunct topical antibiotics: results from the Hiroshima Study. Diabetes Res Clin Pract, 100(1), 53-60.
Bharti P, Katagiri S, Nitta H, Nagasawa T, Kobayashi H, Takeuchi Y, Izumiyama H, Uchimura I. (2013). Periodontal treatment with topical antibiotics improves glycemic control in association with elevated serum adiponectin in patients with type 2 diabetes mellitus. Obes Res Clin Pract, 7(2), 129-138.
Promsudthi A, Pimapansri S, Deerochanawong C, Kanchanavasita W. (2005). The effect of periodontal therapy on uncontrolled type 2 diabetes mellitus in older subjects. Oral dis, 11(5), 293-298.
Mealey BL. (1996). Periodontal implications: medically compromised patients. Ann Periodontol, 1(1), 256-321.
Santos VR, Ribeiro FV, Lima JA, Napimoga MH, Bastos MF, Duarte PM. (2010). Cytokine levels in sites of chronic periodontitis of poorly controlled and well-controlled type 2 diabetic subjects. J Clin Periodontol, 37(12), 1049-1058.
Ribeiro FV, de Mendonça AC, Santos VR, Bastos MF, Figueiredo LC, Duarte PM. (2011). Cytokines and bone-related factors in systemically healthy patients with chronic periodontitis and patients with type 2 diabetes and chronic periodontitis. J Periodontol, 82(8), 1187-1196.
Lehne RA. (2013). Pharmacology for nursing care. 8th ed. Philadelphia: Saunders.
Downloads
Published
How to Cite
Issue
Section
License
Srinakharinwirot University Journal of Sciences and Technology is licensed Under a Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International (CC-BY-NC-ND 4.0) License, Unless Otherwise Stated. Please Read Journal Policies Page for More Information on Open Access, Copyright and Permissions.
