Citation Information :
Syed NK. Effects of Nonsurgical Periodontal Therapy on Glycemic Control in Diabetic Patients under Systemic Administration of Antidiabetic Ayurvedic Drug. J Contemp Dent Pract 2023; 24 (7):481-484.
Aim: This study aimed to monitor the metabolic response of nonsurgical periodontal therapy in type-2 diabetic patients with chronic periodontitis under systemic administration of antidiabetic ayurvedic drug.
Materials and methods: About 90 newly diagnosed mild-to-moderate forms of type-2 diabetes mellitus (DM) subjects with generalized chronic periodontitis were selected according to the inclusion and exclusion criteria and were randomly divided into group A and group B with 45 patients in each group. Clinical parameters, including plaque index, probing pocket depth, clinical attachment level, and glycemic status, were assessed at baseline. Following initial periodontal clinical examination, the drug Nishamalaki (NA) 2 gm twice daily for 3 months was prescribed after food by an Ayurvedic physician to all the patients enrolled in group A and group B, and scaling and root planing were completed only for group B patients. Patients were recalled for review, and all the parameters were reassessed at the end of the 1st, 2nd, and 3rd months following interventions.
Results: Regarding clinical and metabolic parameters at baseline, no statistically significant differences were displayed between the two groups. However, at the 3-months follow-up period, the patients in group B demonstrated significantly better clinical and metabolic outcomes than patients in group A.
Conclusion: Periodontal therapy improved glycemic control in patients with type-2 DM in both groups; however, the reduction in FBS values reached statistical significance only in the group receiving scaling and root planing alone.
Clinical significance: Nonsurgical periodontal therapy may have a beneficial effect on the periodontal clinical and glycemic levels in type-2 diabetic patients with chronic periodontitis.
Zhang L, Henson BS, Camargo PM, et al. The clinical value of salivary biomarkers for periodontal disease. Periodontology 2000 2009;51:25–37. DOI: 10.1111/j.1600-0757.2009.00315.x.
Page RC, Kornman KS. The pathogenesis of human periodontitis: An introduction. Periodontology 2000. 1997;14:9–11. DOI: 10.1111/j.1600-0757.1997.tb00189.x.
Bullon P, Newman HN, Battino M. Obesity, diabetes mellitus, atherosclerosis and chronic periodontitis: A shared pathology via oxidative stress and mitochondrial dysfunction? Periodontol 2000 2014;64(1):139–153. DOI: 10.1111/j.1600-0757.2012.00455.x.
Popawska-Kita A, Siewko K, Szpak P, et al. Association between type 1 diabetes and periodontal health. Adv Med Sci 2014;59(1):126–131. DOI: 10.1016/j.advms.2014.01.002.
Lalla E, Cheng B, Lal S, et al. Periodontal changes in children and adolescents with diabetes. Diabetes Care 2006;29(2):295–299. DOI: 10.2337/diacare.29.02.06.dc05-1355.
Mealey BL. Periodontal disease and diabetes: A two-way street. J Am Dent Assoc 2006;137 Suppl:26S–31S. DOI: 10.14219/jada.archive.2006.0404.
Campus G, Salem A, Uzzau S, et al. Diabetes and periodontal disease: A case-control study. J Periodontol 2005;76(3):418–425. DOI: 10.1902/jop.2005.76.3.418.
Tsai C, Hayes C, Taylor GW. Glycemic control of type 2 diabetes and severe periodontal disease in the US adult population. Community Dent Oral Epidemiol 2002;30(3):182–192. DOI: 10.1034/j.1600-0528.2002.300304.x.
Nassar H, Kantarci A, Van Dyke TE. Diabetic periodontitis: A model for activated innate immunity and impaired resolution of inflammation. Periodontol 2000 2007;43:233–244. DOI: 10.1111/j.1600-0757.2006.00168.x.
Nesse W, Abbas F, van der Ploeg I, et al. Periodontal inflamed surface area: Quantifying inflammatory burden. J Clin Periodontol 2008;35(8):668–673. DOI: 10.1111/j.1600-051X.2008.01249.x
Nibali L, D'Aiuto F, Griffiths G, et al. Severe periodontitis is associated with systemic inflammation and a dysmetabolic status: A case-control study. J Clin Periodontol 2007;34(11):931–937. DOI: 10.1111/j.1600-051X.2007.01133.x.
Saxena A, Vikram NK. Role of selected Indian plants in management of type 2 diabetes: A review. J Altern Complement Med 2004;10(2):369–378. DOI: 10.1089/107555304323062365.
Joseph R, Nagrale AV, Joseraj MG, et al. Low levels of serum vitamin D in chronic periodontitis patients with type 2 diabetes mellitus: A hospital-based cross-sectional clinical study. J Indian Soc Periodontol 2015;19(5):501–506. DOI: 10.4103/0972-124X.167162.
Eke PI, Page RC, Wei L, et al. Update of the case definitions for population-based surveillance of periodontitis. J Periodontol 2012;83(12)1449–1454. DOI: 10.1902/jop.2012.110664.
Buzinin SM, Alabsi AM, Boon Tan AT, et al. Effects of nonsurgical periodontal therapy on clinical response, microbiological profile, and glycemic control in Malaysian subjects with type 1 diabetes. Scientific WorldJournal 2014;2014:232535. DOI: 10.1155/2014/232535.
Sinha S, Sonoo PR, Siddhartha R, et al. Effect of conventional periodontal treatment (scaling and root planing) on type-2 diabetic patient with moderate generalized chronic periodontitis: A clinical study. J Pharm Bioallied Sci 2021;13(Suppl 1):S706–S710. DOI: 10.4103/jpbs.JPBS_692_20.
ICMR Guidelines for Management of Type 2 Diabetes 2018.
Khan SB, Kapoor A, Nema SK, et al. A comparative study: Elevated HbA1C and fasting blood sugar levels in clinically suspected cases of Type-II DM. Int J Pathol: Res Pract 2018;7(8).
Chahkandi T, Taheri F, Bijari B, et al. Prevalence of high normal FBS and prediabetes among adolescents in Birjand, East of Iran. J Educ Health Promot 2015;4:68. DOI: 10.4103/2277-9531.162389.
Bedarkar PB. Alpha amylase and alpha glucosidase inhibitory activity of Amalaki Rasayana-An Ayurvedic formulation. Journal of Pharmaceutical Research 2017;6(11):994–1002. DOI: 10.20959/wjpr201711-9641.
Kashinath S, Sharma J, Kumar S, et al. A clinical study on the efficacy of wheat grass juice in Prameha. Int Res J Pharmacy 2012;(3)4. DOI: 10.7897/2230-8407.
Punchihewa TKG, Ekneligoda RV, Uyanege PP. Evaluation of the acute effect of Nishamalaki Churna in the management of blood glucose level in diabetes mellitus type 2. Int J Sci Res Eng Dev 2021;4(1). ISSN: 2581-7175.
Mirunalini S, Krishnaveni M. Therapeutic potential of Phyllanthus emblica (amla): The ayurvedic wonder. J Basic Clin Physiol Pharmacol 2010;21(1):93–105. DOI: 10.1515/jbcpp.2010.21.1.93.
Fatima N, Hafizur RM, Hameed A, et al. Ellagic acid in Emblica officinalis exerts anti-diabetic activity through the action on β-cells of pancreas. Eur J Nutr 2017;56(2):591–601. DOI: 10.1007/s00394-015-1103-y.
Ruoyan C, Qiulan L, Qiqi W, et al. Effect of non-surgical periodontal therapy on glycemic control of type 2 diabetes mellitus: A systematic review and Bayesian network meta-analysis. BMC Oral Health 2019;19(1):176. DOI: 10.1186/s12903-019-0829-y.
Mizuno H, Ekuni D, Maruyama T, et al. The effects of non-surgical periodontal treatment on glycemic control, oxidative stress balance and quality of life in patients with type 2 diabetes: A randomized clinical trial. PLoS One 2017;12(11):e0188171. DOI: 10.1371/journal.pone.0188171.