Pattayil Simna, Vadakkekuttical Rosamma Joseph, Radhakrishnan Chandni, Kanakkath Harikumar, Hrishi Thayyil Sivaraman
Department of Periodontics, Government Dental College, Affiliated to Kerala University of Health Sciences, Calicut, Kerala, India.
Department of Emergency Medicine, Government Medical College, Affiliated to Kerala University of Health Sciences, Calicut, Kerala, India.
J Periodontol. 2023 Jan;94(1):31-40. doi: 10.1002/JPER.22-0085. Epub 2022 Aug 3.
Treatment of diabetes includes oral antidiabetic drugs (OAD), insulin, or their combinations. Insulin can achieve faster glycemic control and have anabolic action on bone. This study was undertaken to assess the prevalence and severity of periodontitis, and to estimate the proportional relationship between periodontal inflamed surface area, clinical attachment loss, and glycated hemoglobin (HbA1c) level in patients with type 2 diabetes (T2DM) on OAD therapy and on insulin therapy.
This cross-sectional study comprised 130 patients with T2DM on OAD therapy (OAD group) and 130 patients with T2DM on insulin therapy (INSULIN group). All patients were assessed for sociodemographic, behavioral characteristics, clinical history, periodontal parameters (bleeding on probing, probing depth, clinical attachment loss [Clinical AL], Oral Hygiene Index-simplified, plaque index, and periodontal inflamed surface area [PISA]), and biochemical variables (HbA1c, fasting plasma glucose, postprandial plasma glucose).
Prevalence, extent, and severity of periodontitis and PISA were lower in the INSULIN group as compared with the OAD group. A proportional relationship was observed between HbA1c and PISA and between HbA1c and Clinical AL. A unit increase in HbA1c is associated with an increase in PISA of 130.47 mm and an increase in Clinical AL of 0.182 mm.
A proportional relationship was observed between PISA, clinical attachment loss, and HbA1c level in patients with type 2 diabetes mellitus on insulin therapy and OAD therapy. Despite comparable oral hygiene status and glycemic control between the two groups, the periodontal parameters were lesser in the INSULIN group as compared with the OAD group.
糖尿病的治疗包括口服抗糖尿病药物（OAD）、胰岛素或两者联合使用。胰岛素能够更快地控制血糖，并对骨骼具有合成代谢作用。本研究旨在评估2型糖尿病（T2DM）患者在接受OAD治疗和胰岛素治疗时牙周炎的患病率和严重程度，并估计牙周炎症表面积、临床附着丧失与糖化血红蛋白（HbA1c）水平之间的比例关系。
这项横断面研究包括130例接受OAD治疗的T2DM患者（OAD组）和130例接受胰岛素治疗的T2DM患者（胰岛素组）。对所有患者进行社会人口统计学、行为特征、临床病史、牙周参数（探诊出血、探诊深度、临床附着丧失[临床AL]、简化口腔卫生指数、菌斑指数和牙周炎症表面积[PISA]）以及生化变量（HbA1c、空腹血糖、餐后血糖）的评估。
与OAD组相比，胰岛素组牙周炎的患病率、范围和严重程度以及PISA较低。观察到HbA1c与PISA之间以及HbA1c与临床AL之间存在比例关系。HbA1c每增加一个单位，PISA增加130.47mm，临床AL增加0.182mm。
在接受胰岛素治疗和OAD治疗的2型糖尿病患者中，观察到PISA、临床附着丧失与HbA1c水平之间存在比例关系。尽管两组的口腔卫生状况和血糖控制相当，但胰岛素组的牙周参数低于OAD组。
