glycemic index C D A J O U R N A L , V O L 5 0 , Nº 5
Management of the Glycemic Index Through Periodontal Management With Pharmacological Agents Christian Pretto, DDS; Joshua Tordjman, DDS; and Aviv Ouanounou, BSc, MSc, DDS
abstract Background: Periodontitis and its negative effects on systemic health can affect patients with Type 2 diabetes mellitus (T2DM) and glycemic management in particular. The chronic inflammatory response elicited in response to the bacterial biofilm present in individuals with periodontitis may propagate the chronic inflammation seen in patients with T2DM. Types of studies: This review focuses on current literature exploring the management of periodontitis through pharmacological agents and nonsurgical treatment to regulate the glycemic index in T2DM patients. Results: Chronic periodontitis can affect glycemic control and influence the development and severity of diabetic complications. A cyclical relationship can be formed where uncontrolled hyperglycemia propagates a chronic inflammatory response leading to both increased insulin resistance and increased damage to periodontal tissues. Practical implications: Current evidence suggests that scaling and root planing significantly reduce HbA1c levels in T2DM patients with chronic periodontitis, however, the use of antibiotics to treat periodontitis as adjuncts is equivocal in this matter. Doxycycline and minocycline may have an effect if administered locally, however, more research is needed. Similarly, there is limited research examining the effect of azithromycin on glycemic control. Keywords: Periodontitis, diabetes, SRP, HbA1c, antibiotics
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