Efficacy of Systemic Administration of Alpha Lipoic Acid and Scaling and Root Planning in Patients with Chronic Periodontitis and Type 2 Diabetes Mellitus-A Randomised Controlled Trial

Abstract

Introduction: Both diabetes and periodontitis are globally rampant diseases with common risk factors. Current evidence points to a bidirectional inter-relationship between diabetes and periodontitis and it has been hypothesised that inflammation, lipids and adipokines may mediate this relationship. Resistin is an adipokine whose levels are elevated in patients with insulin resistance. Oxidative stress has a pivotal role to play in the progression of both the diseases, and antioxidants like Alpha Lipoic Acid (ALA) and Non Surgical Periodontal Therapy (NSPT) may improve the disease outcome. Aim: To evaluate the effect of systemic administration of ALA as an adjunct to Scaling and Root Planing (SRP) on serum resistin levels and Glycated Haemoglobin (HbA1c) in patients with chronic periodontitis and type 2 diabetes mellitus. Materials and Methods: This study was a randomised interventional single blinded clinical trial conducted on 40 patients, 18 males and 22 females, aged between 35 and 60 years. Subjects with type 2 diabetes and chronic periodontal disease were recruited in the study. The samples were equally divided into groups A and B. A total of 20 patients in group A were administered ALA systemically, 600 mg thrice a day for three months after SRP, whereas 20 patients in group B underwent SRP only. Clinical parameters like Gingival Index (GI), Probing Pocket Depth (PPD), and Clinical Attachment Levels (CAL) as well as the HbA1c and serum resistin levels were measured at baseline and three months after NSPT. Intragroup comparison was done by paired t-test for continuous data and Wilcoxon signed rank test for score data and intergroup comparison was done by unpaired t-test for continuous data and Mann Whitney U test for score data. Data was analysed by Statistical Package for Social Sciences (SPSS) version 22.0. Results: Both group A (test) and group B (control) showed significant improvement in relation to clinical parameters, as well as HbA1c and serum resistin levels, however when an intergroup comparison was made, patients in group A showed statistically significant results over group B. Conclusion: ALA systemically administered after NSPT in the test group proved to be efficacious in improving the clinical parameters as well as in reducing the levels of serum resistin and HbA1c.

Keywords

• clinical parameters
• quantitative sandwich enzyme immunoassay technique
• spectrophotometric analysis