Effects of Metronidazole as an Adjunct to Non-Surgical Periodontal Therapy on Insulin Resistance in Type 2 Diabetics

Abstract

Treating periodontitis with metronidazole (MET) as an adjunct to scaling root planing (SRP) is suggested to have inconsistent effects on insulin resistance (IR) in type 2 diabetes mellitus (T2DM). This paper will present the effects of MET, in addition to SRP, on the homeostatis model assessment of IR (HOMA-IR). A three-arm clinical trial was conducted and analyses were performed on T2DM participants with periodontitis (n = 74) who completed follow-up visits at 3 and 6 months after the intervention. The observed between-group and within-group mean changes in IR were found using ANOVA with repeated measures, followed by a post-hoc analysis, and a p-value of ≤0.05 was considered significant. Between-group analyses showed no difference in the HOMA-IR at 3 months, but at 6 months the difference was significant (p = 0.046). Within-group analyses showed that the HOMA-IR was significantly reduced in both test groups (p ≤ 0.05) over the period of time. Adjunct use of MET may result in a sudden short-term lowering of the HOMA-IR level within 3 months that may not be retained over 6 months when compared to the sustained lowering of the HOMA-IR levels in T2DM when intervened with SRP without MET.

Grafting resveratrol onto mesoporous silica nanoparticles towards efficient sustainable immunoregulation and insulin resistance alleviation for diabetic periodontitis therapy

“…7 Therefore, clinicians only have to select conventional therapeutic strategies that involve three main steps: (1) glycemic control, (2) regular periodontal non-surgical treatment, and (3) antibiotic administration. 8,9 Although it has demonstrated a certain extent of efficacy in alleviating diabetic periodontitis (DP), 10 a plethora of related clinical trials have revealed no significant differences in the serum levels of key critical pro-inflammatory cytokines such as TNF-α and IL-6 before and after therapy. 11–13 In addition, related research studies have also claimed that this strategy played a limited role in alleviating the IR level of diabetes.…”

“…[11][12][13] In addition, related research studies have also claimed that this strategy played a limited role in alleviating the IR level of diabetes. 8,14 What's worse, antibiotic use is not routinely recommended due to the increased bacterial drug resistance which is detrimental to the human body. 9,15 Periodontitis is caused by the confrontation between pathogenic microorganisms and various immune cells in the tissue.…”