Effect of Periodontal Therapy on Glycemic Control in Type2 Diabetes

Objectives: Periodontal therapy is suggested to have a positive impact on blood glucose levels in individuals with type 2 diabetes. However, studies that specifically investigate the influence of baseline hemoglobin A1c (HbA1c) levels are lacking. This study aimed to elucidate the impact of periodontal therapy on glycemic control in individuals with type 2 diabetes, considering various baseline blood glucose levels, using a large-scale claims database in Japan.
Methods: Using the JMDC Claims Database, we identified individuals with type 2 diabetes who underwent health checkup in the fiscal years 2018 or 2019 and were followed until the next year's checkup. We conducted a weighted cohort analysis using stabilized inverse probability weights for treatment and censoring to estimate the effect of periodontal therapy on changes in HbA1c levels within a year. Analysis was conducted for different baseline hemoglobin HbA1c categories: 6.5−6.9, 7.0−7.9, and ≥8.0%.
Results: Of the 4,279 individuals included in the study, 957 received periodontal therapy. The mean baseline HbA1c levels were 7.6% (standard deviation [SD], 1.2) for the periodontal therapy group and 7.7% (SD, 1.3) for the no dental visit group. There were 1,382 (32.3%), 1,767 (41.3%), and 1,130 (26.4%) with the baseline HbA1c levels of 6.5–7.0%, 7.0–7.9%, and 8% or higher, respectively. Overall, there was a tendency towards improved glycemic control among those who received periodontal therapy. Individuals with baseline HbA1c levels of 7.0–7.9% who received periodontal therapy exhibited significantly better glycemic control compared to those without dental visits (difference; −0.107 [95% confidence interval, −0.198 to −0.015]).
Conclusions: Periodontal therapy may improve glycemic control in individuals with diabetes, particularly in those with HbA1c levels ≥ 7.0%. Medical professionals and individuals with type 2 diabetes should be aware of the importance of dental health in the management of type 2 diabetes.