Periodontal conditions and treatment outcomes for subjects with diabetes mellitus : special emphasis on HbA1c levels and T-cells

A two way relationship between periodontal disease (PD) and diabetes mellitus has previously been reported. This thesis was aimed to further analyze the influence of PD on blood glucose levels of subjects with type 2 diabetes mellitus (T2D) and vice versa. Periodontal conditions (bleeding on probing [BOP], plaque index [PI], periodontal pocket depth [PPD] [4mm < 6mm and ≥ 6mm]) and marginal bone levels) were investigated in subjects with pre-diabetes as well as those with or without diabetes mellitus. HbA1c levels in individuals with periodontal disease and diabetes mellitus were analyzed after non-surgical and surgical treatments. This thesis also assessed the influence of diabetes on infiltration of inflammatory cells, T lymphocytes and B lymphocytes in gingiva and the effect of glucose control on T-cell motility. AIMS: Study I aimed to evaluate the difference in periodontal conditions between subjects with prediabetes, well or poorly controlled diabetes mellitus and non-diabetes. Hemoglobin A1c levels, BMI and WC were also measured. Study IIaimed to study the effect of periodontal treatment (non-surgical and surgical) on HbA1c levels in subjects with or without PD and with or without diabetes mellitus. HbA1c, BOP, PI and PPD 4mm <6mm; ≥6mm were recorded. Study III aimed to investigate the infiltration of T and B lymphocytes in gingival biopsies of diabetic and non-diabetic subjects with or without periodontal disease. Study IVexamined the influence of D-glucose on T cell motility. RESULTS: In study I, thirty-seven percent of all individuals who reported to be non-diabetics were prediabetics. An increase in the number of PPD ≥ 6mm was seen in subjects with poorly controlled diabetes as compared to pre-diabetics and non-diabetics (P<0.05). In study II, periodontal inflammatory conditions in all groups improved with non-surgical and surgical treatment. Subjects with diabetes mellitus showed decreased levels in HbA1c over a period of 3 and 6 months. No changes were detected in PPD 4mm