Outcomes of Periodontal Treatment in Diabetes Mellitus Patients at Kiruddu Referral Hospital in Uganda. A Prospective Cohort Study

Introduction: Periodontitis is a common complication of diabetes mellitus associated with poor glycemic control. The relationship between periodontal disease and glycemic control in patients with diabetes mellitus remains unclear. This study set out to determine the outcomes of periodontal treatment in diabetic patients in Uganda. Methods: Using a cohort study design, 41 adult diabetic patients with periodontal disease were enrolled and followed up for 3 months. Fasting blood sugar, glycated hemoglobin levels, pocketprobing depth, bleeding and clinical attachment loss at baseline and 3 months after periodontal treatment were determined. Gingival crevicular fluid was assessed to detect presence of Porphyromonas gingivalis, Aggregatibacter actinomycetemcomitans, Bacteroides forsythus and Fusobacterium nucleatum. Data were analyzed using R version 4.10. Mean differences were calculated to determine effect of treatment and multiple logistic regressions was used to determine association between Hba1c and the different variables.Results: Of the41 participants, 61% were females while 39% were males. The average age was 49.2 years (S.D = 11.2)while the mean BM1 was 27.8 (S.D = 4.8). Overall, there was a reduction in the average number of teeth with bleeding sites, those with pockets and the frequencies of selected bacteria except Fusobacterium nucleatum at 3 months after periodontal treatment. Following periodontal treatment, 39% of the participants had an improvement in their glycemic control (mean HbA1c reduction of 1.86) with age < 47.1 years, diabetic duration less than 1.6 years, BM1< 27.7 and HBA1c >8.9 at baseline being positively associated with this improvement. Conclusion: Treating periodontal disease in diabetic patients especially those with HBA1c <9.0 can improve glycemic control. However, larger studies need to be conducted to ascertain why some patients fail to attain an improved metabolic control following this intervention.