IADR Abstract Archives
Periodontal Treatment Decreases the Levels of HbA1c: Real-World Clinical Setting
Objectives: To assess the effectiveness of periodontal treatment (PT) on glycated hemoglobin A1c (HbA1c) levels in patients with type 2 diabetes mellitus (T2DM) in a real-world clinical setting of the Chilean public healthcare system.
Methods: A prospective observational cohort study was conducted at two primary care centers in Chile between March 2023 and March 2024 to evaluate the effects of a specialist provided PT on patients with T2DM currently enrolled in a national program to treat this disease (Cardiovascular Health Program). The intervention was compared to a group of patients on the waiting list for PT during the same period. Groups were matched 1:1 through Propensity Score Matching (PSM) using age, sex, years of T2DM diagnosis, metabolic control at baseline, time between HbA1c tests, and insulin requirement. The propensity score was estimated using probit regression of the treatment on the covariates and then matched using cardinality matching. A generalized linear regression model with differences in HbA1c levels from baseline as the outcome and the treatment, covariates, and their interaction as predictors was fitted and then contrasted between both groups using a Mann-Whitney test, with a significance level of p<0.05.
Results: 55 participants were observed in the intervention group. After 9 patients left the follow-up and PSM, a sample of 19 matched individuals was studied. All standardized mean differences for the covariates used for matching were below 0.1, indicating good balance between groups. PT group had a median reduction in HbA1c levels of 1.47% (95% CI -2.41,-0.53; p=0.002) compared to control group (-1.67 vs -0.20, respectively), after 6 months of follow-up.
Conclusions: PT demonstrates a clinically and statistically significant reduction in HbA1c levels in patients with T2DM in a real-world clinical setting in Chile compared to the current standard. These findings reinforce the importance of including periodontal care in the policies of treatment for T2DM.
Methods: A prospective observational cohort study was conducted at two primary care centers in Chile between March 2023 and March 2024 to evaluate the effects of a specialist provided PT on patients with T2DM currently enrolled in a national program to treat this disease (Cardiovascular Health Program). The intervention was compared to a group of patients on the waiting list for PT during the same period. Groups were matched 1:1 through Propensity Score Matching (PSM) using age, sex, years of T2DM diagnosis, metabolic control at baseline, time between HbA1c tests, and insulin requirement. The propensity score was estimated using probit regression of the treatment on the covariates and then matched using cardinality matching. A generalized linear regression model with differences in HbA1c levels from baseline as the outcome and the treatment, covariates, and their interaction as predictors was fitted and then contrasted between both groups using a Mann-Whitney test, with a significance level of p<0.05.
Results: 55 participants were observed in the intervention group. After 9 patients left the follow-up and PSM, a sample of 19 matched individuals was studied. All standardized mean differences for the covariates used for matching were below 0.1, indicating good balance between groups. PT group had a median reduction in HbA1c levels of 1.47% (95% CI -2.41,-0.53; p=0.002) compared to control group (-1.67 vs -0.20, respectively), after 6 months of follow-up.
Conclusions: PT demonstrates a clinically and statistically significant reduction in HbA1c levels in patients with T2DM in a real-world clinical setting in Chile compared to the current standard. These findings reinforce the importance of including periodontal care in the policies of treatment for T2DM.