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<p>To evaluate the effects of integrated self-management interventions on objectively measured clinical periodontal parameters and systemic metabolic health in community-dwelling individuals with type 2 diabetes (T2DM) and periodontitis. From June to August 2022, 784 adults with T2DM and mild-to-moderate periodontitis from Nanjing communities were randomly allocated to a control group (G0), a periodontitis intervention group (G1), a diabetes intervention group (G2), and a comprehensive intervention group (G3), with 196 participants in each group in this randomized controlled trial. From September to November 2022, the respective intervention groups received three-month, structured self-management programs, while G0 received standard care. Outcomes—including oral health behaviors, probing depth (PD), clinical attachment loss (CAL), fasting plasma glucose (FPG), glycated hemoglobin (HbA1c) level, healthy lifestyle score, and body mass index (BMI)—were assessed at baseline (T0), immediately post-intervention (T1), 3 months (T2), and 6 months (T3) post-intervention. Data were analyzed using Generalized Estimating Equations. A total of 747 participants completed the trial (mean age = 65.26 ± 7.72 years). Periodontal improvements were most pronounced at T3, where both PD and CAL were significantly decreased in G3 compared with G0 (PD: mean difference = −&#xa0;0.253&#xa0;mm, <i>P</i> = 0.009; CAL: mean difference = − 0.429&#xa0;mm, <i>P</i> = 0.017). At T2, G3 demonstrated greater FPG reduction than G0 (mean difference = −&#xa0;0.687 mmol/L, <i>P</i> = 0.003) and lower HbA1c than G1 (mean difference = −&#xa0;0.387%, <i>P</i> = 0.001). The comprehensive intervention group (G3) exhibited greater improvements in blood glucose level and clinical periodontal health compared to the other two intervention groups. Compared with G0, the comprehensive intervention significantly improved patients’ oral health behaviors (≥ 2 kinds; mean difference = 22.8%, <i>P</i> &lt; 0.001) and health lifestyle scores (mean difference = 0.287 points, <i>P</i> &lt; 0.001) at T1, and significantly reduced BMI at T3 (mean difference = −&#xa0;1.470&#xa0;kg/m<sup>2</sup>; <i>P</i> &lt; 0.001). The integrated self-management interventions significantly improved clinical periodontal parameters (PD and CAL), oral health behaviors, blood glucose levels, health lifestyle scores, and BMI in patients with T2DM and periodontitis.</p><p>Trial registration: ChiCTR2100052301, registered on October 24, 2021.</p>

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Integrated self-management interventions improve oral and metabolic health in community-dwelling adults with type 2 diabetes and periodontitis

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月3日

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  • Yi Zhang,
  • Nan Zhou,
  • Yijia Chen,
  • Chenchen Wang,
  • Hao Xu,
  • Xin Hong

摘要

To evaluate the effects of integrated self-management interventions on objectively measured clinical periodontal parameters and systemic metabolic health in community-dwelling individuals with type 2 diabetes (T2DM) and periodontitis. From June to August 2022, 784 adults with T2DM and mild-to-moderate periodontitis from Nanjing communities were randomly allocated to a control group (G0), a periodontitis intervention group (G1), a diabetes intervention group (G2), and a comprehensive intervention group (G3), with 196 participants in each group in this randomized controlled trial. From September to November 2022, the respective intervention groups received three-month, structured self-management programs, while G0 received standard care. Outcomes—including oral health behaviors, probing depth (PD), clinical attachment loss (CAL), fasting plasma glucose (FPG), glycated hemoglobin (HbA1c) level, healthy lifestyle score, and body mass index (BMI)—were assessed at baseline (T0), immediately post-intervention (T1), 3 months (T2), and 6 months (T3) post-intervention. Data were analyzed using Generalized Estimating Equations. A total of 747 participants completed the trial (mean age = 65.26 ± 7.72 years). Periodontal improvements were most pronounced at T3, where both PD and CAL were significantly decreased in G3 compared with G0 (PD: mean difference = − 0.253 mm, P = 0.009; CAL: mean difference = − 0.429 mm, P = 0.017). At T2, G3 demonstrated greater FPG reduction than G0 (mean difference = − 0.687 mmol/L, P = 0.003) and lower HbA1c than G1 (mean difference = − 0.387%, P = 0.001). The comprehensive intervention group (G3) exhibited greater improvements in blood glucose level and clinical periodontal health compared to the other two intervention groups. Compared with G0, the comprehensive intervention significantly improved patients’ oral health behaviors (≥ 2 kinds; mean difference = 22.8%, P < 0.001) and health lifestyle scores (mean difference = 0.287 points, P < 0.001) at T1, and significantly reduced BMI at T3 (mean difference = − 1.470 kg/m2; P < 0.001). The integrated self-management interventions significantly improved clinical periodontal parameters (PD and CAL), oral health behaviors, blood glucose levels, health lifestyle scores, and BMI in patients with T2DM and periodontitis.

Trial registration: ChiCTR2100052301, registered on October 24, 2021.