The Effect of Antimicrobial Periodontal Treatment on Circulating Tumor Necrosis Factor‐Alpha and Glycated Hemoglobin Level in Patients With Type 2 Diabetes

Abstract

Background: Tumor necrosis factor‐α (TNF‐α) may play an important role in insulin resistance. In this study, we hypothesized that TNF‐α produced due to periodontal inflammation synergistically affects insulin resistance as well as TNF‐α produced from adipose tissues in insulin‐resistant type 2 diabetes patients. Therefore, to understand the effects of antimicrobial periodontal therapy on serum TNF‐α concentration and subsequent metabolic control of diabetes, we examined the periodontal and diabetic status on 13 type‐2 diabetes patients. Methods: These patients were treated with local minocycline administration in every periodontal pocket around all existing teeth once a week for a month. Before and after treatment, the number of total bacteria in the periodontal pockets and circulating TNF‐α concentration were measured and the HbA1c value was assessed. Results: Antimicrobial therapy significantly reduced the number of microorganisms in periodontal pockets (P <0.01). After treatment, the circulating TNF‐α level was significantly reduced (P <0.015). The HbA1c value was also reduced significantly (P <0.007). In addition, the 6 patients who were not receiving insulin therapy demonstrated decreased fasting insulin levels (P <0.03), and HOMA‐R (P <0.03) indices. The average reductions in circulating TNF‐α concentration and HbA1c value were 0.49 pg/ml and 0.8%, respectively. Conclusion: The results indicate that anti‐infectious treatment is effective in improving metabolic control in diabetics, possibly through reduced serum TNF‐α and improved insulin resistance. J Periodontol 2001;72:774‐778.