Effects of periodontal non-surgical therapy plus azithromycin on glycemic control in patients with diabetes: a randomized clinical trial
, , , , , , , . Effects of periodontal non-surgical therapy plus azithromycin on glycemic control in patients with diabetes: a randomized clinical trial. J Periodont Res 2013; doi: 10.1111/jre.12058.
Background and Objective
Periodontitis
may alter the systemic condition in patients with diabetes and hence
interfere with glycemic control. The objective of this study was to
determine the quantifiable changes in glycated hemoglobin (HbA1C) after
periodontal non-surgical therapy plus azithromycin in a mixed population
of patients with poorly controlled diabetes.
Materials and Methods
One
hundred and five patients were randomized to receive non-surgical
therapy plus azythromycin (AZ-Sca =33), non-surgical therapy plus
placebo (PB-Sca = 37) and supragingival prophylaxis plus azithromycin
(AZ-Pro = 35). Glycated hemoglobin, glycemia and periodontal parameters
were measured at baseline, 3, 6 and 9 mo after treatment.
Results
Periodontal
parameters were improved in the AZ-Sca and PB-Sca groups as compared to
the AZ-Pro group. A greater reduction in probing depth was observed in
the AZ-Sca as compared to the PB-Sca group. Improvement in clinical
attachment level was similar between AZ-Sca and PB-Sca groups. A
reduction from 8.0% to 7.2% (∆0.8%; p < 0.05) in HbA1C was
observed in the AZ-Sca at 9 mo as compared to the PB-Sca group in which
the reduction was from 7.9% to 7.6% (∆0.3%). There was no decrease in
HbA1C in the AZ-Pro group over time. Mean glycemia values decreased from
195 mg/dL to 159.2 mg/dL (∆35.8 mg/dL; p < 0.05) in the
AZ-Sca group whereas a decrease from 194 mg/dL to 174.8 mg/dL
(∆19.2 mg/dL) in the PB-Sca group at 9 mo was observed. There were no
differences between the AZ-Sca and PB-Sca groups for glycemic
parameters. No improvement in glycemic values in the AZ-Pro group was
observed.
Conclusions
A
modest improvement in glycemic control was detected with a trend
towards the use of non-surgical therapy plus AZ as compared to the
placebo.
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