Does periodontal care improve glycemic control? The Department of Veterans Affairs Dental Diabetes Study

Authors

  • Judith A. Jones,

    1. VA Center for Health Quality, Outcomes and Economic Research, Bedford, MA, USA
    2. Boston University School of Dental Medicine, Boston, MA, USA
    3. Boston University School of Public Health, Boston, MA, USA
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  • Donald R. Miller,

    1. VA Center for Health Quality, Outcomes and Economic Research, Bedford, MA, USA
    2. Boston University School of Public Health, Boston, MA, USA
    3. Massachusetts VA Epidemiology Research and Information Center (MAVERIC), Boston VA Health Care System, Boston, MA, USA
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  • Carolyn J. Wehler,

    1. VA Center for Health Quality, Outcomes and Economic Research, Bedford, MA, USA
    2. Boston University School of Dental Medicine, Boston, MA, USA
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  • Sharron E. Rich,

    1. VA Center for Health Quality, Outcomes and Economic Research, Bedford, MA, USA
    2. Boston University School of Public Health, Boston, MA, USA
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  • Elizabeth A. Krall-Kaye,

    1. VA Center for Health Quality, Outcomes and Economic Research, Bedford, MA, USA
    2. Boston University School of Dental Medicine, Boston, MA, USA
    3. Massachusetts VA Epidemiology Research and Information Center (MAVERIC), Boston VA Health Care System, Boston, MA, USA
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  • Linda C. McCoy,

    1. VA Center for Health Quality, Outcomes and Economic Research, Bedford, MA, USA
    2. Boston University School of Dental Medicine, Boston, MA, USA
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  • Cindy L. Christiansen,

    1. VA Center for Health Quality, Outcomes and Economic Research, Bedford, MA, USA
    2. Boston University School of Public Health, Boston, MA, USA
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  • James A. Rothendler,

    1. VA Center for Health Quality, Outcomes and Economic Research, Bedford, MA, USA
    2. Boston University School of Public Health, Boston, MA, USA
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  • Raul I. Garcia

    1. Boston University School of Dental Medicine, Boston, MA, USA
    2. Massachusetts VA Epidemiology Research and Information Center (MAVERIC), Boston VA Health Care System, Boston, MA, USA
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Address:
Judith A. Jones
Department of General Dentistry
Boston University School of Dental Medicine
Rm. 612A
100 East Newton St.
Boston, MA 02118
E-mail: judjones@bu.edu

Abstract

Objectives: Report results of a randomized-clinical trial of the efficacy of periodontal care in the improvement of glycemic control in 165 veterans with poorly controlled diabetes over 4 months.

Methods: Outcomes were change in Haemoglobin A1c (HbA1c) in the Early Treatment versus untreated (Usual Care) groups and percent of participants with decreases in HbA1c. Analyses included simple/multiple variable linear/logistic regressions, adjusted for baseline HbA1c, age, and duration of diabetes.

Results: Unadjusted analyses showed no differences between groups. After adjustment for baseline HbA1c, age, and diabetes duration, the mean absolute HbA1c change in the Early Treatment group was −0.65%versus−0.51% in the Usual Care group (p=0.47). Adjusted odds for improvement by 0.5% in the Early Treatment group was 1.67 (95% confidence interval: 0.84, 3.34, p=0.14). Usual Care subjects were twice as likely to increase insulin from baseline to 4 months (20%versus 11%, p=0.12) and less likely to decrease insulin (1%versus 6%, p=0.21) than Early Treatment subjects. Among insulin users at baseline, more increased insulin in the Usual Care group (40%versus 21%, p=0.06).

Conclusions: No significant benefit was found for periodontal therapy after 4 months in this study; trends in some results were in favour of periodontal treatment.

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