Journal of Diabetes & Clinical Practice
Open Access

Background and Objectives: DM and periodontitis are two chronic and customary diseases with close relationship together affecting public health and quality of life. The aim of this study was to research the effect of resveratrol supplementation in adjunct with non-surgical periodontal treatment (NST) on blood sugar , triglyceride, periodontal status and inflammatory markers in type 2 diabetic patients with periodontitis . Materials and Methods: This double-blind clinical test study was conducted on 43 diabetic patients with periodontitis mentioned the Endocrinology Clinic at Golestan Hospital in Ahvaz, Iran. All subjects were randomly assigned into two groups of intervention and control. The intervention and control groups received either 480 mg/d resveratrol or placebo capsules (2 PCs) for four weeks. All subjects underwent non-surgical periodontal therapy during the intervention period. Anthropometric parameters, 24-hour dietary recall, fasting blood glucose , insulin, insulin resistance (HOMA-IR), triglycerides, pocket depth (PD), IL6 and TNFα were evaluated altogether subjects pre- and post-intervention. Results: The mean serum levels of fasting insulin and insulin resistance (HOMA-IR) were significantly (P=0.02, P=0.045, respectively) lower within the intervention group compared with the control group (10.42 ± 0.28 and 10.92 ± 0.9; 3.66 ± 0.97 and 4.49 ± 1.56, respectively ). Moreover, significant difference (P < 0.001) was obtained within the mean pocket depth (PD) between the intervention and control groups (2.35 ± 0.6 and 3.38 ± 0.5, respectively) post-intervention. within the intervention group, the mean serum level of IL6 was reduced significantly (P= 0.039) post-intervention (1.58 ± 1.06 and 2.19± 1.09). No significant differences were seen in the mean levels of fasting blood glucose, triglycerides, IL6 and TNFα between the 2 groups postintervention. Conclusions: it's suggested that resveratrol could also be recommended as adjuvant therapy along side non-surgical periodontal treatment in diabetic patients with periodontitis . Keywords: Type 2 DM , periodontitis , Resveratrol, Insulin resistance, Inflammatory markers Introduction: Diabetes mellitus and periodontitis are referred to as two global common and chronic diseases consistent with the planet Health Organization (WHO) statistics, the prevalence of DM was about 382 million people within the world in 2013, reaching 438 million in 2030. On the opposite hand, it's indicated that quite 2/3 of the planet the population are affected by periodontitis. there's a two-way relationship between these two diseases in order that DM may increase the danger of periodontitis and the other way around. it had been reported that the prevalence of severe periodontitis is approximately 39 to 59.6% higher in diabetic than non-diabetic patients. the danger of periodontal the disease is 3 times greater in diabetic subjects than in non-diabetic subjects. periodontitis may be a chronic inflammatory and communicable disease , affecting tissues supporting teeth, and is characterized by gingival bleeding, pocket formation, alveolar bone destruction, animal tissue degradation, and tooth loss. periodontitis increases insulin resistance and thereby may disturb glycemic control. it's been found that controlling blood glucose is six times lower in diabetic patients with periodontitis than in diabetic patients without periodontitis. It has also been indicated that type 2 diabetic patients with periodontitis have higher levels of inflammatory markers like IL-1β, TNFα and IL-6. Materials and Methods: 1.Samples and study design: This randomized doubleblind, placebo-controlled, clinical test was conducted in Ahvaz Golestan Hospital, Iran. The diabetic patients pertaining to the Endocrinology Clinic with some symptoms of periodontitis were mentioned Dental Clinic for further diagnosis. With an influence of 95%, the entire number of required subjects for this study was 40 people. The Homa-IR (24) was used for sample size calculation. Regarding with the inclusion and exclusion criteria, 50 patients (36 females and 14 males) were recruited. the themes were randomly allocated into two groups of intervention (n = 25) and control (n = 25). Inclusion criteria included having age between 30 and 60 years, body mass index 18.5-30 kg/m2 , confirmed DM (no quite five years since diagnosis), FBS less than 22mmol/L, and moderate periodontitis . Exclusion criteria included affected by DM complications like renal failure , pregnancy, breastfeeding, traveling quite fortnight , smoking, using immunosuppressive medications, using insulin, periodontal treatment history during the past six months, using any antioxidants, and considerable changes in diet over the past six months. B.Anthropometric and nutritional assessments: Anthropometric indices including height, weight and waist-hip ratio were measured at the start and end of the study. Weight was measured by a Seca scale (Germany) to the closest of 0.1 kg, and height was measured employing a stadiometer to the closest of 0.1 cm. Waist circumference (widest area between the sting of lower rib and iliac corset) and hip circumference (the largest pelvic girth) were measured to the closest of 0.1 cm. C.Biochemical measurements: A fasting blood sample (5 ml) was obtained from all subjects pre- and post-intervention. All samples were centrifuged, and therefore the serum samples were maintained in -70°C freezer until the day of study except some samples for analyzing FBS. Serum levels of FBS, insulin, insulin resistance (HOMAIR), triglyceride (TG), IL6 and TNFα were evaluated. FBS was immediately measured by enzymatic method using laboratory kits (Pars Azmoon, Tehran, Iran) and an auto-unalyzer. Serum level of insulin decided by ELISA method using laboratory kit (Monobind ,USA). TG was also measured by colorimetric method using the laboratory kits of Pars Azmoon (Tehran, Iran). Conclusion: In the present study, resveratrol supplementation improved insulin resistance and periodontal status in diabetic patients with periodontitis after four weeks. it's suggested that using resveratrol as a dietary supplement with anti-inflammatory and anti-bacterial properties in adjunction with non-surgical periodontal treatments could also be helpful in controlling the periodontal status followed by controlling some complications in DM . Therefore, it is suggested that using resveratrol supplementation and foods rich in resveratrol could also be beneficial in diabetic patients with periodontitis.