[ad_1]
/ dpa
London – A randomized study on the consistent treatment of periodontal disease, a frequently underestimated risk factor for type 2 diabetes, has been reported Lancet Diabetes & Endocrinology (2018, doi: 10.1016 / S2213-8587 (18) 30038-X) long-term glycemic value HbA1 C greatly reduced the patient.
There is a mutual relationship between diabetes and periodontitis. On the one hand, an increase in blood sugar levels promotes infection of the gums, on the other hand, people with poor oral hygiene are at increased risk of developing type 2 diabetes .
According to the results of a recent survey Journal of Clinical Periodontology (2018, doi: 10.1111 / JCPE.13005) from Finland, the incidence of type 2 diabetes was 32% higher among participants whose periodontal pockets were 4 to 5 millimeters deep than those 15 years of age and over. late without periodontitis (rate ratio 1.32, 95% confidence interval: 0.69 to 2.53). For participants with a depth of 6 months or more in the periodontal pockets, the risk was even increased by 56% (rate ratio 1.56, 0.84-2.92).
The increased risk of diabetes is attributed to the release of cytokines from the inflamed gingiva, which are thought to promote insulin resistance. In this case, the treatment of periodontitis should have a hypoglycemic effect. That's exactly what dentists at the Eastman Dental Institute in London studied in a randomized study of 264 patients with type 2 diabetes and periodontitis.
Patients were randomized to receive standard care or intensive periodontal treatment. Intensive treatment has removed deposits and deposits below the gingival margin throughout the oral cavity (subgingival scaling). If necessary, surgical rehabilitation has taken place. Then, a professional cleaning of the teeth was proposed to the participants every 3 months.
The evaluation criterion of the study was the development of HbA1 CValues over one year. As reported by Francesco D'Aiuto and colleagues at the Eastman Dental Institute, the average HbA level1 CInitial value in both groups: 8.1%. After 12 months, the HbA1 CThe value increased to 8.3% in the peer group, while it fell to 7.8% in patients for whom intensive periodontal treatment was proposed.
After taking into account the initial HbA1 CAge, bad, ethnicity, smoking, duration of diabetes and body mbad index were increased to HbA1 CThe value has improved by 0.6 percentage points (95% confidence interval from 0.3 to 0.9), which, according to D 'Aiuto, is roughly equivalent to Effect obtained by type 2 diabetes with an additional hypoglycemic agent.
Since the study was not blinded, a placebo effect can not be completely ruled out. Patients may have been encouraged to change their lifestyle by increasing their periodontal treatment. For Dr. Aiuto, however, it is clear that the prevention and treatment of gum disease could be a new and important way to help people with type 2 diabetes manage their disease and reduce risk of late complications. © heat / aerzteblatt.de
Source link
