To clinically and microbiologically evaluate the association of periodontitis and pre-diabetes. The trial was designed as a randomized controlled clinical trial with a sample size of total of 100 with 1:1 gender ratio. Test group taken were patients with chronic periodontitis with prediabetes and Control group were patients with periodontitis without prediabetes. Body mass index (BMI), Periodontal Probing Depth (PPD),Bleeding on probing (BOP),Clinical Attachment Loss(CAL) using UNC colour coded periodontal probe were recorded. The microbial load in pre-diabetes patients was assessed using samples collected from the periodontal pockets ≤5mm. Fasting Blood sugar (FBS), Post Prandial blood sugar (PPBS), Fasting Insulin were recorded at baseline, 6 weeks,12 weeks and after Non-surgical periodontal therapy (SRP) after taking consent from the patient. The data collected were entered into Microsoft excel 2018. Statistical analysis was done using IBM SPSS Statistics for Windows, Version 27.0. Armonk, NY: IBM Corp. Descriptive analyses were done. Student’s t-test, repeated measures of ANOVA were used for determination of the significance of HOMA-IR, HOMA- β mean differences between and within the groups. In both test and control groups, there was a significant difference (p<0.0001) in probing depth, CAL, gingival bleeding index from baseline to the post treatment (NSPT) till 12 week period. When these clinical parameters were evaluated and correlated with HOMA-IR, HOMA-β, BMI, FBS, post prandial blood sugar at regular intervals, significant (p<0.0001) decrease in HOMA-IR, HOMA-β, BMR, post prandial blood sugar was observed in test group when compared to control group. There is a significant association between prediabetes state and periodontitis. Early diagnosis of periodontitis and a proper treatment in prediabetic group can prevent the progression of prediabetic condition to diabetes and vise versa.
Periodontitis is often associated with diabetes and might be considered one of the chronic complications of diabetes mellitus (DM), both in Type 1 (T1DM) and Type 2 (T2DM). This cross sectional study was designed to evaluate the possible association between clinical periodontal disease status and glycemic levels in diabetes patients (T2DM) among the population of city Hyderabad, INDIA. A total of 200 individuals were examined and out of which 179 were enrolled fulfilling the selection criteria were initially given a health questionnaire to gather information regarding their demographic data, oral hygiene practices. Based on Fasting plasma glucose (FPG) levels, they were grouped into: Good, Moderately and Poorly controlled Type 2 Diabetic patients. Oral hygiene index-simplified, CPI and clinical attachment level (CAL), Tooth mobility and Tooth loss due to mobility were evaluated. Nearly Half the individuals have good glycemic control. (47.5% are <121mg/dl), 29.1% have moderately controlled (<121-180mg/dl), 23.5% have poorly controlled (<181-240mg/dl) plasma sugar levels. Average Patients showed 5-10 years of diabetic history with 121- 180mg/dl fasting plasma glucose (FPG) levels. Average participants had fair OHI-S scores. Patients with Good FPS levels showed fair oral hygiene status. Community periodontal index (CPI) scores showed (14.52%) Gingivitis, (20.11%) mild, (8.93%) moderate, (2.79%) severe periodontitis patients with good controlled FPS Levels. Average CAL values ranged between 3-5mm in good to moderately controlled FPS levels. Tooth mobility and tooth loss is less in over all participants. Patients with high plasma sugar levels were more susceptible for severe periodontal disease. CPI values and mobility of teeth was less in subjects with FPG<126mg/dl. With Loss of attachment up to 5mm was observed. Both Periodontist and Diabetologist individually and together should improve awareness regarding periodontal health and diabetic control.
Diabetes is an endocrinological disorder with a rapidly increasing number of patients globally. Over the last few years, the alarming status of diabetes has become a pivotal factor pertaining to morbidity and mortality among the youth as well as middle-aged people. Current developments in our understanding related to autoimmune responses leading to diabetes have developed a cause for concern in the prospective usage of immunomodulatory agents to prevent diabetes. The mechanism of action of vaccines varies greatly, such as removing autoreactive T cells and inhibiting the interactions between immune cells. Currently, most developed diabetes vaccines have been tested in animal models, while only a few human trials have been completed with positive outcomes. In this review, we investigate the undergoing clinical trial studies for the development of a prototype diabetes vaccine.
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