There is compelling epidemiological and clinical evidence to suggest that periodontal infection adversely affects glycemic control in people with non-insulin-dependent diabetes mellitus (NIDDM). However, this topic has not yet been extensively studied. The purpose of this project is two-fold: (1) to demonstrate that it is feasible to identify and recruit a sufficient number of subjects who would be eligible and willing to participate in an intervention trial evaluating the effects of treating periodontal infection on glycemic control in people with NIDDM, and (2) to conduct preliminary studies of the relationships among glycemic control, periodontal infection and tumor necrosis factor-alpha (TNF-alpha).
The specific aims of this proposed project are: (1) to determine the number of potentially eligible people with NIDDM registered in the University of Michigan Hospital Diabetes Center Unit (UMHDCU) patient population for inclusion in a sampling frame to conduct adequate subject recruitment for the subsequent intervention study; (2) to estimate the number of UMHDCU registered patients necessary to contact in order to obtain a sufficient number of eligible subjects for the subsequent intervention study participation; (3) to determine the distribution of important subject characteristics related to diabetes and periodontal status in order to establish a feasible set of stratifying variables for a block randomization strategy planned for the forthcoming intervention study proposal; and (4) to evaluate the joint relationships among diabetes control, periodontal health (using clinical and microbiological measures), and TNF-alpha levels (from both gingival crevicular fluid and serum). Results from this pilot project will be used to support an immediate follow-up proposal to NIH for funding an R01 to conduct the intervention study, """"""""Treatment of Periodontitis in Poorly Controlled NIDDM: 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 NIDDM could be substantiated as an important component in management of NIDDM. Additionally, data and specimens collected will permit preliminary analyses of joint relationships among periodontal infection, glycemic control, and TNF-alpha, potentially important associations that have not been previously investigated.
