Does periodontal care improve glycemic control? The Department of Veterans Affairs Dental Diabetes Study
: Judith A. Jones
: Blackwell Synergy
Objectives: Report results of a randomized-clinical trial of the efficacy of periodontal
care in the improvement of glycemic control in 165 veterans with poorly controlled
diabetes over 4 months.
Methods: Outcomes were change in Haemoglobin A1c (HbA1c) in the Early
Treatment versus untreated (Usual Care) groups and percent of participants with
decreases in HbA1c. Analyses included simple/multiple variable linear/logistic
regressions, adjusted for baseline HbA1c, age, and duration of diabetes.
Results: Unadjusted analyses showed no differences between groups. After
adjustment for baseline HbA1c, age, and diabetes duration, the mean absolute HbA1c
change in the Early Treatment group was 0.65% versus 0.51% in the Usual Care
group (p50.47). Adjusted odds for improvement by 0.5% in the Early Treatment
group was 1.67 (95% confidence interval: 0.84, 3.34, p50.14). Usual Care subjects
were twice as likely to increase insulin from baseline to 4 months (20% versus 11%,
p50.12) and less likely to decrease insulin (1% versus 6%, p50.21) than Early
Treatment subjects. Among insulin users at baseline, more increased insulin in the
Usual Care group (40% versus 21%, p50.06).
Conclusions: No significant benefit was found for periodontal therapy after 4 months
in this study; trends in some results were in favour of periodontal treatment.
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