Managing Periodontitis in Type 1 Diabetic Patients Improves Glycemic Control: A Case Report



diabetes, periodontitis, glycated hemoglobin assay, diabetes camp, Diabetes Self-Management Education


This case report describes the long-term follow-up of a 22-year-old, female patient with type 1 diabetes managed by conservative oral care and glycemic control measures. She is on a twice a day insulin regimen. Tooth numbers 13 and 37 had pockets less than 6 mm while all remaining teeth had greater than 6 mm. Periodontal management consisted of root planing combined with instructions on diabetes self-management skills at home. Nine weeks after the first sextant was treated, Pocket depth measurements in 93 (81.6%) out of 114 sites and bleeding on probing (BOP) scores in 11 (57.9%) out of 19 teeth decreased. There was a 50% reduction in the C reactive Protein and a 46.7% decrease in the fructosamine assay levels. Initial glycohemoglobin level of 8.3% decreased substantially to 7.1%. The goal of the dentist is no longer just the improvement of oral health but ultimately the overall health of the patient and the physician’s goal is to include oral health in the promotion of overall health.


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Author Biography

Edmund Julian Ofilada, St. Luke's Medical Center

Consultant, Dentistry and Oral Surgery Service St. Luke's Medical Center


Diabetes Control and Complications Trial Research Group (DCCT). The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. New Engl J Med. 1993;329(14):977–86.

American Diabetes Association. Standards of medical care in diabetes-2016. Diabetes Care. 2016;39(Suppl 1):S39-46.

Stratton IM, Adler AI, Neil HA, Mathews DR, Manley SE, Cull CA, et al. Association of glycaemia with macrovascular and microvascular complications of type 2 diabetes (UKPDS 35): Prospective observational study. Br Med J. 2000;321(7258): 405–12.

Simpson TC, Needleman I, Wild SH, Moles DR, Mills EJ. Treatment of periodontal disease for glycaemic control in people with diabetes. Aust Dent J. 2010;55(4):472-4.

Aldridge JP, Lester V, Watts TLP, Collins A, Viberti G, Wilson RF. Single-blind studies of the effects of improved periodontal health on metabolic control in type 1 diabetes mellitus. J Clin Periodontol. 1995;22(4): 271–5.

Smith GT, Greenbaum CJ, Johnson BD, Persson GR. Short-term responses to periodontal therapy in insulin-dependent diabetic patients. J Periodontol. 1996;67(8):794–802.

Westfelt E, Rylander H, Blohmé G, Jonasson P, Lindhe J. The effect of periodontal therapy in diabetics. Results after 5 years. J Clin Periodontol. 1996;23(2):92–100.

Llambés F, Silvestre FJ, Hernández-Mijares A, Guiha R, Caffesse R. The effect of periodontal treatment on metabolic control of type 1 diabetes mellitus. Clin Oral Investig. 2008;12(4):337–43.

Williams RC Jr, Mahan CJ. Periodontal disease and diabetes in young adults. JAMA 1960;172(8):776-8.

Miller LS, Manwell MA, Newbold D, et al. The relationship between reduction in periodontal inflammation and diabetes control: A report of 9 cases. J Periodontol 1992;63(10):843-8.

Ebersole JL, Cappelli, D. Acute-phase reactants in infections and inflammatory diseases. Periodontology 2000. 2000;23(1):19–49.

Glurich I, Grossi S, Albini B, Ho A, Shah R, Zeid M, et al. Systemic inflammation in cardiovascular and periodontal disease: Comparative study. Clin Vaccine Immunol. 2002;9(2):425–32.

Loos BG. Systemic markers of inflammation in periodontitis. J Periodontol. 2005;76(11s):2106–15.

Paraskevas S, Huizinga JD, Loos BG. A systematic review and metaanalyses on C-reactive protein in relation to periodontitis. J Clin Periodontol. 2008;35(4):277–90. 10.1111/j.1600-051X.2007.01173.x.

Treszl A, Szereday L, Doria A, King GL, Orban T. Elevated C-reactiveprotein levels do not correspond to autoimmunity in type 1 diabetes. Diabetes Care. 2004;27(11):2769-70.

Davidson MB, Schriger DL, Peters AL, Lorber B. Glycosylated hemoglobin as a diagnostic test for type 2 diabetes mellitus. J Am Med Assoc. 2000:283(5):606-7.

Mealey BL, Ocampo GL. Diabetes mellitus and periodontal disease. Periodontol 2000. 2007;44(1):127-53.

Institute of Medicine report on the quality of healthcare. Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press, 2003.

Flexner A. Medical education in the United States and Canada: A report to the Carnegie Foundation for the Advancement of Teaching. New York: Carnegie Foundation, 1910.

Gies WJ. Dental education in the United States and Canada: A report to the Carnegie Foundation for the Advancement of Teaching. New York: Carnegie Foundation, 1926.

Association of American Medical Colleges. Report IX Contemporary Issues in Medicine: Oral Health Education for Medical and Dental Students, June 2008.

Sastrowijoto SH, van der Velden U, van Steenbergen TJ, Hillemans P, Hart AA, de Graaff J, et al. Improved metabolic control, clinical periodontal status and subgingival microbiology in insulin dependent diabetes mellitus. A prospective study. J Clin Periodontol. 1990;17(4):233–42.

Klein HA, Jackson SM, Street K, Whitacre JC, Klein G. Diabetes Self-Management Education: Miles to go. Nursing Research and Practice. 2013;2013.



How to Cite

Ofilada, E. J. (2016). Managing Periodontitis in Type 1 Diabetic Patients Improves Glycemic Control: A Case Report. Journal of the ASEAN Federation of Endocrine Societies, 31(2), 160. Retrieved from



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