There is compelling epidemiological and clinical evidence to suggest that periodontal infection adversely affects glycemic control in people with type 2 disbetes mellitus, though this topic has not yet been extensively studied. This study tests the feasibility of identifying and recruiting sufficient subjects for a clinical trial to evaluate the effects of treating peridontal infection on glycemic control for people with type 2 diabetes mellitus and evaluated relationships among glycemic control, peridontal infection and TNF(for preliminary data). The source population is ~50% male/female and 10-20% minority (over 95% African-American); all are adults 18 years old and older. The U-M Hospital Diabetes Center Unit, Adult Endocrinology Clinics, and Hypertension clinic database and medical records will be used to develop a sampling frame with minorities oversampled for recruitment. Human subjects (n=450) will participate in a mail survey (or follow-up telephone interview for mail survey non-responders) with a subsample (n=150) recruited for a screening examination/interview session. The mail/telephone survey will involve 300 individuals with poorly controlled type 2 diabetes (GlyHb equal to above 7.8%), 75 with better control (GlyHb less 7.8%), and 75 without diabetes. The mail/telephone survey will include a brief project description and questions about demographics; oral health; diabetes, hypertension and other medical conditions; health behaviors; and willingness to particiapte in the pilot screening visit and future. Consent for the mail survey will be assumed from completion and return of the questionnaire. An informational letter precedes the telephone interview, providing a toll-free phone number to call if individuals do not wish to be contacted. The screening session involves 150 randomly selected dentate responders of the mail/telephone survey who agreed to participate; 100 with diabetes in poorer control, 25 in better control, and 25 without diabetes. Procedures include: obtaining consent; health-related interview; periodontal examination; brief physical examination (height, weight, blood pressure), and collection of dental plaque, gingival crevicular fluid, and blood samples. Results from this pilot project will be used to support an immediate follow-up proposal to NIH for funding an R-01 to conduct the intervention study, """"""""Treatment of Periodontitis in Poorly Controlled Type 2 Diabetes: Effect on Glycemic Control"""""""". If results from the clinical trial provide evidence that treating periodontal infection contributes to improved glycemic control, then diagnosis and treatment of periodontal infection in subjects with type 2 diabetes could be substantiated as an important component in management of type 2 diabetes. Additionally, data and specimens collected will permit preliminary analyses of joint relationships among periodontal infection, glycemic control, and TNF, potentially important associations that have not been previously investigated.
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