LAUSR

BACKGROUND Treatment of diabetes includes oral anti-diabetic drugs (OAD), insulin, or their combinations. Insulin can achieve faster glycemic control and have anabolic action on bone. This study was undertaken to assess the prevalence and severity of periodontitis, and to estimate the dose-response relationship between periodontal inflamed surface area, clinical attachment loss, and glycated hemoglobin level in type 2 diabetic patients(T2DM) on OAD therapy and on insulin therapy. METHODS This cross-sectional study comprised 130 T2DM patients on OAD therapy (OAD group) and 130 T2DM patients on insulin therapy (INSULIN group). All patients were assessed for socio-demographic, behavioral characteristics, clinical history, periodontal parameters [Bleeding on Probing(BOP),Probing Pocket Depth(PPD),Clinical Attachment Loss (CAL), Oral Hygiene Index-simplified (OHI-S), Plaque Index(PI), and Periodontal Inflamed Surface Area (PISA)], and biochemical variables[HbA1c,Fasting Plasma Glucose (FPG), Post Prandial Plasma Glucose (PPG)]. RESULTS Prevalence, extent, and severity of periodontitis and PISA were lower in the INSULIN group as compared to the OAD group. A proportional relationship was observed between HbA1c and PISA and between HbA1c and CAL. A unit increase in HbA1c is associated with an increase in PISA of 130.47 mm2 and an increase in CAL of 0.182mm. CONCLUSION A proportional relationship was observed between periodontal inflamed surface area, clinical attachment loss, and glycated hemoglobin level in patients with type 2 diabetes mellitus on insulin therapy and OAD therapy. Despite comparable oral hygiene status and glycemic control between the two groups, the periodontal parameters were lesser in the INSULIN group as compared to the OAD group. This article is protected by copyright. All rights reserved.