Preliminary evaluation of the impact of periodontal treatment on markers of glycaemic control in dogs with diabetes mellitus: A prospective, clinical case series

Abstract

BackgroundPeriodontal disease (PD) can adversely affect glycaemic control in humans. However, it is unknown if a similar association exists in dogs.MethodsTen client‐owned dogs with poorly regulated diabetes mellitus (DM) and PD were prospectively enrolled. A complete blood count, serum biochemistry, urinalysis and measurement of C‐reactive protein, interleukin‐6 (IL‐6), tumour necrosis factor‐α, haemoglobin A1c (HbA1c) and fructosamine concentrations were performed before periodontal treatment (PT) and monthly thereafter for 3 months. A periodontal disease severity score (PDSS) was determined during PT. The effects of time post‐PT and PDSS on markers of inflammation and glycaemic control were determined by generalised estimating equation analysis.ResultsHbA1c (mean; 95% confidence interval [CI]) decreased 3 months post‐PT (32.1 mmol/mol; 21.1–43.1 mmol/mol vs. 44.3 mmol/mol; 36.4–52.0; p = 0.003). PDSS at enrolment was significantly (p = 0.031) positively associated with HbA1c concentration. Due to a significant (p < 0.001) interaction between PDSS and time post‐PT in the analysis of fructosamine, dogs with low (1–3) PDSS and high (7–9) PDSS were analysed separately. Fructosamine (mean; 95% CI) significantly decreased 1 month post‐PT (570 μmol/L; 457–684 μmol/L vs. 624 μmol/L; 499–748; p = 0.001) in the high PDSS group but not in the low PDSS group. Fructosamine concentration upon enrolment and PDSS were correlated (r = 0.73, p = 0.017). IL‐6 concentration significantly decreased 3 months post‐PT (9.9 pg/mL; 8.5–11.3 pg/mL vs. 11.2 pg/mL; 9.7–12.7; p = 0.002).LimitationsLimitations of the study included the small number of dogs, the lack of a control group and the inability to assess PDSS during follow‐ups.ConclusionsThese findings support a potential detrimental interaction between PD and DM. The apparent beneficial effect of PT on markers of glycaemic control was most conspicuous in dogs with more severe PD.

Progesterone-Related Diabetes Mellitus in the Bitch: Current Knowledge, the Role of Pyometra, and Relevance in Practice

“…In this scenario, the role played by the inflammatory environment in inducing additional insulin resistance seemed to explain worsened insulin sensitivity due to pyometra compared with the isolated diestrus influences [ 16 ]. Chronic inflammation due to obesity [ 116 , 117 , 118 , 119 ] or periodontitis [ 120 , 121 ], leading to insulin resistance, represents other examples of the negative effect of inflammation on insulin sensibility in dogs. These findings allowed the assumption that conditions such as diestrus and pyometra can exert insulin resistance at the IR and post-IR levels, and mechanisms such as IR upregulation represent a potential peripheral compensatory modulation [ 52 , 79 , 81 ].…”