ABSTRACT
Background:
The interaction between type 2 diabetes and periodontal disease underscores the importance of exploring dietary interventions that could mitigate inflammation and improve periodontal health in diabetic patients.
Materials and Methods:
This randomized controlled trial included 100 patients with type 2 diabetes who were equally divided into two groups: Group A (low-carbohydrate diet) and Group B (control group). Patients in Group A followed a low-carbohydrate diet for 12 weeks, while Group B maintained their regular dietary habits. Periodontal health was assessed using clinical parameters such as probing depth (PD) and clinical attachment level (CAL), and inflammation was measured by analyzing levels of C-reactive protein (CRP) and interleukin-6 (IL-6). Statistical analyses were performed using appropriate tests.
Results:
After 12 weeks, Group A exhibited significant improvements in periodontal health compared to Group B. The mean PD reduction was 0.5 mm in Group A and 0.1 mm in Group B, with a corresponding mean CAL gain of 0.3 mm in Group A and no significant change in Group B. Inflammatory markers also showed favorable outcomes in Group A, with a decrease of 1.2 mg/L in CRP levels and 20% reduction in IL-6 levels. In contrast, Group B demonstrated minimal changes in inflammatory markers. The differences in PD, CAL, CRP, and IL-6 levels between the two groups were statistically significant (P < 0.05).
Conclusion:
The adoption of a low-carbohydrate diet for 12 weeks demonstrated significant improvements in periodontal health and reduction of inflammation in patients with type 2 diabetes.
KEYWORDS: C-reactive protein, clinical parameters, inflammation, interleukin-6, low-carbohydrate diet, periodontal health, randomized controlled trial, type 2 diabetes
INTRODUCTION
The interplay between type 2 diabetes and periodontal disease has garnered substantial attention due to the bidirectional relationship between these conditions. Periodontal disease can negatively impact glycemic control in diabetic patients, while diabetes itself can exacerbate periodontal inflammation.[1,2]
Dietary strategies have emerged as potential adjunctive approaches to manage diabetes and ameliorate periodontal inflammation. Among these, low-carbohydrate diets have gained prominence for their potential to improve glycemic control and reduce inflammation.[3] A low-carbohydrate diet restricts the intake of refined sugars and starchy foods, leading to lower blood glucose levels and potentially mitigating the inflammatory response associated with periodontal disease.[4]
The rationale for investigating the relationship between diet, diabetes, and periodontal health is reinforced by the complex pathophysiology shared by these conditions. Elevated blood glucose levels in diabetes contribute to oxidative stress, impaired immune response, and compromised tissue repair mechanisms, all of which are relevant to periodontal disease progression.[5] By exploring the impact of a low-carbohydrate diet, this study seeks to provide insights into the potential synergistic effects of dietary interventions in managing diabetes and periodontal health.
In this context, the present study aims to assess the effect of a low-carbohydrate diet on periodontal health and inflammation in patients with type 2 diabetes. By investigating clinical parameters such as PD and CAL, as well as measuring levels of inflammatory markers, this study endeavors to contribute valuable evidence for the development of integrated therapeutic approaches for diabetic patients at risk of periodontal complications.
MATERIALS AND METHODS
Study design
This randomized controlled trial aimed to investigate the effect of a low-carbohydrate diet on periodontal health and inflammation in patients with type 2 diabetes. The study was conducted in accordance with ethical guidelines and received approval from the Institutional Review Board.
Participants
A total of 100 patients with diagnosed type 2 diabetes were recruited for this study. Participants were randomly assigned to two groups: Group A (low-carbohydrate diet) and Group B (control group). Each group consisted of 50 participants.
Intervention
Participants in Group A were provided with individualized low-carbohydrate dietary plans developed by registered dietitians. The low-carbohydrate diet aimed to restrict carbohydrate intake to less than 50 grams per day, whereas emphasizing the consumption of lean proteins, healthy fats, and non-starchy vegetables. Participants in Group B were instructed to maintain their regular dietary habits throughout the study period.
Periodontal assessment
Baseline periodontal assessments were conducted for all participants, including measurements of PD and CAL at six sites per tooth. These assessments were performed by calibrated examiners using standardized periodontal probes. Periodontal examinations were repeated after 12 weeks.
Inflammatory marker analysis
Blood samples were collected at baseline and at the end of the 12-week intervention period. Serum levels of CRP and interleukin-6 (IL-6) were analyzed using validated enzyme-linked immunosorbent assays.
Statistical analysis
Descriptive statistics were used to summarize participant characteristics and baseline periodontal parameters. Changes in PD, CAL, CRP levels, and IL-6 levels were compared between the two groups using appropriate statistical tests, including independent t-tests and analysis of covariance (ANCOVA).
RESULTS
Participant characteristics
The study included 100 participants, with 50 in each group (Group A: low-carbohydrate diet, Group B: control group). The mean age of participants in Group A was 55 years (range: 45-65), and in Group B, it was 57 years (range: 47-68). The distribution of gender, diabetes duration, and baseline glycemic control (HbA1c levels) was similar between the two groups.
Periodontal parameters
Table 1 presents the changes in periodontal parameters after the 12-week intervention period. In Group A, the mean PD decreased by 0.5 mm, and the mean CAL increased by 0.3 mm. In contrast, Group B showed a minimal decrease of 0.1 mm in PD and no significant change in CAL. The differences in PD and CAL changes between the two groups were statistically significant (P < 0.05).
Table 1.
Changes in periodontal parameters
| Group | Mean change in PD (mm) | Mean change in CAL (mm) |
|---|---|---|
| Group A | -0.5 | 0.3 |
| Group B | -0.1 | 0.0 |
Inflammatory marker analysis
Table 2 presents the changes in inflammatory marker levels after the 12-week intervention period. In Group A, the mean CRP levels decreased by 1.2 mg/L, and the mean interleukin-6 (IL-6) levels decreased by 20%. In Group B, minimal changes in CRP and IL-6 levels were observed. The differences in CRP and IL-6 changes between the two groups were statistically significant (P < 0.05).
Table 2.
Changes in inflammatory marker levels
| Group | Mean change in CRP (mg/L) | Mean change in IL-6 (%) |
|---|---|---|
| Group A | -1.2 | -20 |
| Group B | 0.1 | 2 |
DISCUSSION
The present study aimed to investigate the impact of a low-carbohydrate diet on periodontal health and inflammation in patients with type 2 diabetes. The findings provide valuable insights into the potential benefits of dietary interventions for managing both glycemic control and periodontal health in individuals with diabetes.
The observed improvements in periodontal health parameters in the low-carbohydrate diet group (Group A) align with the notion that dietary modifications can influence periodontal status. Reductions in PD and gains in CAL are indicative of improved periodontal conditions, potentially attributed to the anti-inflammatory and glycemic control effects of a low-carbohydrate diet.[1,2] These outcomes are consistent with studies that have shown positive associations between dietary patterns and periodontal health improvement.[3,4]
The significant reductions in inflammatory markers observed in Group A further support the potential anti-inflammatory effects of a low-carbohydrate diet. Decreases in CRP levels and interleukin-6 (IL-6) levels in this group suggest a systemic anti-inflammatory response that may have contributed to the observed improvements in periodontal health.[5,6] This aligns with research that has demonstrated links between dietary interventions and reductions in systemic inflammation markers.[7,8]
The findings of this study have important implications for the management of individuals with type 2 diabetes and periodontal concerns
CONCLUSION
In conclusion, this study demonstrates that a low-carbohydrate diet has the potential to improve periodontal health parameters and reduce inflammation in patients with type 2 diabetes. These findings highlight the significance of dietary interventions as part of integrated approaches to managing the complex interplay between diabetes and periodontal disease. Clinicians should consider individualized dietary counseling to complement traditional therapies for optimal oral and systemic health outcomes.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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