Control glicémico (hba1c) en pacientes con diabetes mellitus tipo II, bajo tratamiento periodontal no quirúrgico

Abstract

Diabetes mellitus (DM) is a chronic degenerative disease, characterized by the presence of hyperglycemia. It occurs due to deficit in the production or action of insulin, affecting the metabolism of carbohydrates, proteins and fats. This alteration leads in the long term to the development of renal, ocular, nervous and cardiac problems. Periodontal disease can have a significant impact on the metabolic state aggravating the glycemic control in the patient with DM; Thus, in a poorly controlled patient, saliva and gingival crevicular fluid may contain increased amounts of glucose, altering the microflora of the dentobacterial plaque with which it generates a risk factor for PD. Objective: To evaluate the changes of glycosylated hemoglobin (HbA1c) after non-surgical periodontal treatment in patients with Type 2 Diabetes Mellitus. Materials and methods: A quasi-experimental, longitudinal study of repeated measures in a single group (before and after the intervention), since the response of the individuals will be evaluated over a determined time after developing an intervention. The universe will consist of subjects between the ages of 35 and 75, diagnosed with type 2 diabetes mellitus, with a glycosylated hemoglobin (HbA1c) between 6.5% to 9% with periodontal pockets no larger than 6mm. The sample will be composed of those people who attend the medical consultation of the FOSCAL. The sample size was calculated using the Openepi® program, taking into account a confidence level of 95% and an expected change rate of 0 , 4%, and a power of 80%. Results We examined 76 type II diabetic subjects among whom the prevalence of periodontal disease was 52.6%, 36 participants were excluded, therefore 40 subjects were included in the study. The study population included 40 individuals, of whom 39 came to the control for 3 months and only 33 reached the control test for 6 months, 19 men and 21 women, with an average age of 63.2 years SD = 7.06; 97.50% reported being of urban origin and 45% had an educational level of bachelor. Regarding the Delta or difference in HbA1c values ​​after non-surgical periodontal treatment, the delta of the study population, at the 6-month follow-up, was 0.12, that is, at follow-up, HbA1c, increased this value by percentage.