Nonsurgical periodontal therapy remodels oral microbiome-metabolome networks and associates with glycemic and inflammatory improvements in type 2 diabetes mellitus with periodontitis: a 6-month longitudinal study

Background: Periodontitis and type 2 diabetes mellitus (T2DM) have a bidirectional relationship, yet how nonsurgical periodontal therapy (NSPT) affects oral microbiome-metabolome interactions in this comorbidity remains unclear. Objective: To longitudinally characterize oral microbiome and metabolome shifts following NSPT in patients with T2DM and periodontitis, and to relate these shifts to periodontal and systemic outcomes. Design: = 18). Periodontal parameters, glycated hemoglobin (HbA1c), C-reactive protein (CRP), and glucose/lipid markers were measured at baseline, at 3 and 6 months. Oral samples were collected at each visit for microbiome profiling and metabolomics. Microbe-metabolite-clinical features and associations were explored using correlation analyses and pathway annotation. Results: . Selected microbe-metabolite pairs mapped to glutathione and purine metabolism. Conclusion: NSPT reshapes oral microbe-metabolite networks in T2DM with periodontitis, implicating redox-related pathways that may link periodontal therapy to systemic inflammation and glycemic control.