The effect of periodontal therapy on glycemic control and fasting plasma glucose level in type 2 diabetic patients: systematic review and meta-analysis.
The effect of periodontal therapy on glycemic control and fasting plasma glucose level in type 2 diabetic patients: systematic review and meta-analysis.
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DOI：
10.1186/s12903-016-0249-1
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发表时间：
2016-07-30
期刊：
影响因子：
2.9
通讯作者：
Yitayeh A
中科院分区：
文献类型：
--
作者：
Teshome A;Yitayeh A
糖尿病和牙周病有双向关联。然而，牙周治疗对2型糖尿病合并牙周炎患者的血糖控制和/或空腹血糖水平的影响存在两难境地。因此，本综述旨在评估牙周治疗与非牙周治疗对2型糖尿病患者糖化血红蛋白(HbA1c)和空腹血糖水平的影响。使用四个数据库(MEDLINE、Cochrane LIBRARY(CENTAL)、EMBASE和CINAHL)和人工检索(至2015年12月)进行文章检索。我们纳入了随机对照试验，测试牙周治疗对2型糖尿病合并牙周病患者糖化血红蛋白和空腹血糖水平的影响。研究包括2005至2015年间以英文发表的研究。评估了关于随机化、分配顺序隐藏、盲法、结果数据不完整、选择性结果报告和其他偏向的偏倚风险。在文章选择过程后，纳入了7个随机对照试验，涉及940名参与者，主要结果是糖化血红蛋白和/或空腹血糖变化，并有至少3个月的随访。随访3个月后糖化血红蛋白下降0.48(95%CI：0.18~0.78)，干预期结束时下降0.53(95%CI：0.24~0.81)。干预结束后，干预组空腹血糖水平显著下降，为8.95 mg/dl(95%可信区间：4.30~13.61)。合并分析显示，使用抗生素并含漱口水的患者有效值为0.5 1(0.0 3，1.0 0，p = 0.0 4)，未使用辅助治疗的患者有效值为0.5 3(95%CI：0.19，0.87；p = 0.002)。根据埃格的检验，这些研究的发表偏倚为0.066。在这项系统回顾和荟萃分析中，非手术牙周治疗的2型糖尿病和牙周患者的糖化血红蛋白和空腹血糖水平显著降低。
Diabetic mellitus and periodontal disease have bilateral associations. However, there is a dilemma on the effect of periodontal therapy on glycemic control and/or fasting plasma glucose level in type 2 diabetic patients with periodontitis. Therefore, this review aimed to assess the effectiveness of periodontal therapy versus no periodontal therapy on glycated hemoglobin (HbA1c) and fasting plasma glucose level in type 2 diabetic patients. Article searching was done using four databases (MEDLINE, Cochrane library (CENTRAL), EMBASE and CINAHL) and a manual search (until December 2015). We included randomized controlled trials testing the effectiveness of periodontal therapy on glycated hemoglobin and fasting plasma glucose level in patients with type 2 Diabetes mellitus with periodontal disease. Studies published in English between 2005 and 2015 were included. Risk of bias was assessed regarding randomization, allocation sequence concealment, blinding, incomplete outcome data, selective outcome reporting, and other biases. After the article selection process, seven Randomized controlled trials involving 940 participants with a primary outcome of change in glycated hemoglobin and/or fasting plasma glucose and having a minimum of 3 months follow-up were included. There was a reduction of glycated hemoglobin 0.48(95 % CI: 0.18–0.78) after 3 months follow-up and 0.53 (95 % CI: 0.24–0.81) at the end of the intervention period. There was also a significant reduction of fasting plasma glucose level, 8.95 mg/dl (95 % CI: 4.30–13.61) in the intervention group after the end of the intervention. The pooled analysis showed that patients with adjunctive antibiotic therapy and mouth wash had effect size of 0.51(0.03, 1.00, p = 0.04) and it was 0.53 (95 % CI: 0.19, 0.87; p = 0.002) in patients without adjunctive therapy. The publication bias of the studies was 0.066 according to Egger’s test. In this systematic review and meta-analysis, there is a significant reduction of Glycated hemoglobin and Fasting plasma glucose level on type 2 diabetic and periodontal patients with non-surgical periodontal therapy.