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

Yasuichi Munenaga, Toru Yamashina, Junko Tanaka, Fusanori Nishimura

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18 Citations (Scopus)

Abstract

Aims: Periodontal treatment reduces glycated hemoglobin (HbA1) in subjects with type 2 diabetes, although effective strategy for different severities of periodontitis remains unclear. We hypothesized that resolution of periodontitis-induced inflammation by the therapy combined with antibiotics may have beneficial effects on the glycemic control of diabetes. Methods: A total of 523 subjects with type 2 diabetes were screened for periodontal disease. Of these, 160 subjects who visited dentists were divided into two groups according to high-sensitivity c-reactive protein (hsCRP) level: >500. ng/ml and <500. ng/ml. The group with hsCRP over 500. ng/ml was further sub-divided into two groups according to treatment strategy: topical application of antibiotics combined with conventional mechanical debridement (group A), and debridement alone (B). Subjects with hsCRP below 500. ng/ml were sub-divided similarly (C: combination therapy; D: debridement alone). hsCRP was measured after 1 month and changes of HbA1c after 3 months. These parameters were also measured in control subjects (N= 118) who did not visit dentists (E: initial hsCRP > 500. ng/ml; F: hsCRP < 500. ng/ml). Results: A multiple comparison by ANOVA revealed that only group A showed a significant reduction in HbA1c over time (P< 0.001). Multivariable analyses revealed elevated hsCRP and the combination treatment with antibiotics were two independent variables influencing the decrease of HbA1c over the study (P< 0.01 and P< 0.001, respectively). Conclusions: In subjects with type 2 diabetes and periodontitis-induced mild inflammation (hsCRP. > 500. ng/ml), treatment to reduce hsCRP using antibiotics is recommended.

Original languageEnglish
Pages (from-to)53-60
Number of pages8
JournalDiabetes Research and Clinical Practice
Volume100
Issue number1
DOIs
Publication statusPublished - Apr 1 2013
Externally publishedYes

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Glycosylated Hemoglobin A
Type 2 Diabetes Mellitus
Periodontitis
Anti-Bacterial Agents
Inflammation
Proteins
Periodontal Diseases
Dentists
Therapeutics

All Science Journal Classification (ASJC) codes

  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine
  • Endocrinology

Cite this

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title = "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",
abstract = "Aims: Periodontal treatment reduces glycated hemoglobin (HbA1) in subjects with type 2 diabetes, although effective strategy for different severities of periodontitis remains unclear. We hypothesized that resolution of periodontitis-induced inflammation by the therapy combined with antibiotics may have beneficial effects on the glycemic control of diabetes. Methods: A total of 523 subjects with type 2 diabetes were screened for periodontal disease. Of these, 160 subjects who visited dentists were divided into two groups according to high-sensitivity c-reactive protein (hsCRP) level: >500. ng/ml and <500. ng/ml. The group with hsCRP over 500. ng/ml was further sub-divided into two groups according to treatment strategy: topical application of antibiotics combined with conventional mechanical debridement (group A), and debridement alone (B). Subjects with hsCRP below 500. ng/ml were sub-divided similarly (C: combination therapy; D: debridement alone). hsCRP was measured after 1 month and changes of HbA1c after 3 months. These parameters were also measured in control subjects (N= 118) who did not visit dentists (E: initial hsCRP > 500. ng/ml; F: hsCRP < 500. ng/ml). Results: A multiple comparison by ANOVA revealed that only group A showed a significant reduction in HbA1c over time (P< 0.001). Multivariable analyses revealed elevated hsCRP and the combination treatment with antibiotics were two independent variables influencing the decrease of HbA1c over the study (P< 0.01 and P< 0.001, respectively). Conclusions: In subjects with type 2 diabetes and periodontitis-induced mild inflammation (hsCRP. > 500. ng/ml), treatment to reduce hsCRP using antibiotics is recommended.",
author = "Yasuichi Munenaga and Toru Yamashina and Junko Tanaka and Fusanori Nishimura",
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T1 - Improvement of glycated hemoglobin in Japanese subjects with type 2 diabetes by resolution of periodontal inflammation using adjunct topical antibiotics

T2 - Results from the Hiroshima Study

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AU - Yamashina, Toru

AU - Tanaka, Junko

AU - Nishimura, Fusanori

PY - 2013/4/1

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N2 - Aims: Periodontal treatment reduces glycated hemoglobin (HbA1) in subjects with type 2 diabetes, although effective strategy for different severities of periodontitis remains unclear. We hypothesized that resolution of periodontitis-induced inflammation by the therapy combined with antibiotics may have beneficial effects on the glycemic control of diabetes. Methods: A total of 523 subjects with type 2 diabetes were screened for periodontal disease. Of these, 160 subjects who visited dentists were divided into two groups according to high-sensitivity c-reactive protein (hsCRP) level: >500. ng/ml and <500. ng/ml. The group with hsCRP over 500. ng/ml was further sub-divided into two groups according to treatment strategy: topical application of antibiotics combined with conventional mechanical debridement (group A), and debridement alone (B). Subjects with hsCRP below 500. ng/ml were sub-divided similarly (C: combination therapy; D: debridement alone). hsCRP was measured after 1 month and changes of HbA1c after 3 months. These parameters were also measured in control subjects (N= 118) who did not visit dentists (E: initial hsCRP > 500. ng/ml; F: hsCRP < 500. ng/ml). Results: A multiple comparison by ANOVA revealed that only group A showed a significant reduction in HbA1c over time (P< 0.001). Multivariable analyses revealed elevated hsCRP and the combination treatment with antibiotics were two independent variables influencing the decrease of HbA1c over the study (P< 0.01 and P< 0.001, respectively). Conclusions: In subjects with type 2 diabetes and periodontitis-induced mild inflammation (hsCRP. > 500. ng/ml), treatment to reduce hsCRP using antibiotics is recommended.

AB - Aims: Periodontal treatment reduces glycated hemoglobin (HbA1) in subjects with type 2 diabetes, although effective strategy for different severities of periodontitis remains unclear. We hypothesized that resolution of periodontitis-induced inflammation by the therapy combined with antibiotics may have beneficial effects on the glycemic control of diabetes. Methods: A total of 523 subjects with type 2 diabetes were screened for periodontal disease. Of these, 160 subjects who visited dentists were divided into two groups according to high-sensitivity c-reactive protein (hsCRP) level: >500. ng/ml and <500. ng/ml. The group with hsCRP over 500. ng/ml was further sub-divided into two groups according to treatment strategy: topical application of antibiotics combined with conventional mechanical debridement (group A), and debridement alone (B). Subjects with hsCRP below 500. ng/ml were sub-divided similarly (C: combination therapy; D: debridement alone). hsCRP was measured after 1 month and changes of HbA1c after 3 months. These parameters were also measured in control subjects (N= 118) who did not visit dentists (E: initial hsCRP > 500. ng/ml; F: hsCRP < 500. ng/ml). Results: A multiple comparison by ANOVA revealed that only group A showed a significant reduction in HbA1c over time (P< 0.001). Multivariable analyses revealed elevated hsCRP and the combination treatment with antibiotics were two independent variables influencing the decrease of HbA1c over the study (P< 0.01 and P< 0.001, respectively). Conclusions: In subjects with type 2 diabetes and periodontitis-induced mild inflammation (hsCRP. > 500. ng/ml), treatment to reduce hsCRP using antibiotics is recommended.

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