Effectiveness of lifestyle change plus dental care (LCDC) program on improving glycemic and periodontal status in the elderly with type 2 diabetes

Abstract

BackgroundCurrently, there is an increased prevalence of diabetes mellitus among the elderly. To minimize adverse effects on glycemic control, prevention and management of general and oral complications in diabetic patients is essential. The purpose of the present study is to assess the effectiveness of a Lifestyle Change plus Dental Care (LCDC) program to improve glycemic and periodontal status in the elderly with type 2 diabetes.MethodsA quasi-experimental study was conducted in Health Centers 54 (intervention) and 59 (control) from October 2013 to January 2014. 66 diabetic patients per health center were included. At baseline, the intervention group attended a 20 minute lifestyle and oral health education program, individual lifestyle counseling using motivational interviewing (MI), application of self regulation manual, and individual oral hygiene instruction. The intervention group received booster education every visit by viewing a 15 minute educational video. The control group received a routine program. Participants were assessed at baseline and 3 month follow up for glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), body mass index (BMI), periodontal status, knowledge, attitude and practice of oral health and diabetes mellitus. Data were analyzed by using descriptive statistic, Chi-square test, Fisher’s exact test, t-test, and multiple linear regression.ResultsAfter the 3 month follow up, a multiple linear regression analysis showed that the intervention group was significantly negatively correlated in both glycemic and periodontal status. Participants in the intervention group had significantly lower glycosylated hemoglobin (HbA1c), fasting plasma glucose (FPG), plaque index score, gingival index score, pocket depth, clinical attachment level (CAL), and percentage of bleeding on probing (BOP) when compared to the control group.ConclusionsThe combination of lifestyle change and dental care in one program improved both glycemic and periodontal status in the elderly with type 2 diabetes.Trial registrationClinicalTrials.in.th: TCTR20140602001.

A periodontal disease care program for patients with type 2 diabetes: A randomized controlled trial

“…As one goal for periodontal treatment BOP elimination, the decline in the BOP values for the intervention group from 26.2% to 13.7% can be considered clinically significant. In other studies that informed patients with type 2 diabetes about how to brush their teeth more effectively and provided instruction about oral hygiene, the intervention groups showed significant improvements in BOP, which concurs with the current study's results. However, there was no significant change in the intervention group in relation to PPD, which is associated with plaque accumulation.…”

“…However, improvements were not observed in relation to increased PPD, which is a chronic, long‐term condition that worsens with an infection, or chronic inflammation, which was assessed by examining TNF‐α levels. Moreover, reports from studies that investigated the treatment of periodontal disease in diabetic patients have described improvements in HbA1c levels and periodontal disease; similar improvements were seen in studies that educated patients about how to care for periodontal disease and diabetes simultaneously . On the other hand, studies like the current study, which only provided education related to caring for periodontal disease, have demonstrated improvements in periodontal disease, but no significant improvements in HbA1c levels.…”

Effectiveness of Lifestyle Change Plus Dental Care Program in Improving Glycemic and Periodontal Status in Aging Patients with Diabetes: A Cluster, Randomized, Controlled Trial

“…The LCDC program 20 is based on the health‐belief model, social cognitive theory, and cognitive–behavioral theory. The LCDC program used the common risk factor approach, 16 which integrated DM and periodontal disease prevention by LCDC using multiple professionals, including a doctor, two nurse practitioners, two dentists, and two dental assistants.…”

Bolesti usta i zuba kod starih

“…Kvalitet života može se definisati kao stepen do koga neka jedinka može da uživa u svakodnevnim životnim aktivnostima, kao i da na njih utiče na direktan ili indirektan način. Kvalitet života u starosti zavisi i od toga koliko su problemi koje ima stara osoba sa jednom ili više sistemskih oboljenja sanirani [5][6][7][8].…”