# Diabetes reversal and the subgingival microbiota

> **NIH NIH R01** · UNIVERSITY OF PENNSYLVANIA · 2022 · $381,783

## Abstract

Project Summary
Diabetes mellitus increases the prevalence and severity of periodontal diseases. Periodontitis
has a complex bacterial etiology, and the relationship of the bacterial community to diabetes
remains unclear. A potential mechanism for the interaction of periodontitis and diabetes is that
diabetes causes a shift to a more pathogenic bacterial burden as the result of alterations in
substrates such as glucose or inflammatory products that promote growth of certain bacteria.
Studies have established that diabetes enhances susceptibility to infection by pathogenic
bacteria in several target organs, and that diabetes causes a shift in the gut microbiota. Whether
diabetes creates an environment that supports a more pathogenic bacterial community in the
periodontium has not been settled in part because of technical limitations of previous studies.
With advances in approaches to study the dynamics of complex bacterial communities, it is now
possible to compare the microbiota in healthy individuals to diabetics. We plan to obtain
microbial profiles by high throughput Illumina DNA-seq analysis before and after reversal of
diabetes and to examine functional bacterial differences by RNA-Seq. A recent development has
provided an opportunity to compare diabetes and normoglycemia-associated subgingival
bacterial communities. Laparoscopic sleeve gastrectomy surgery produces a rapid resolution of
diabetes in most recipients. The reversal of diabetes has provided new insights into the impact
of diabetes on the gut microbiome. We will advantage of this opportunity to conduct two studies.
One is a cross-sectional analysis to compare the microbiome in diabetics with nondiabetics. The
second is a longitudinal comparison in the same subjects to examine the effect of reversing
diabetes. Because the reversal of diabetes is rapid it facilitates examination of cause and effect
relationships. The two approaches taken (baseline and longitudinal) each has distinct strengths
so we can determine whether diabetes alters the subgingival microbiome to enhance the risk of
periodontitis. This project brings together two leading bariatric surgery programs at Temple
University and the University of Pennsylvania to ensure an adequate patient population to reach
the planned enrollment figures. It also brings together experts in diabetes from Temple
University and University of Pennsylvania, and experts in the oral cavity and oral bacteria from
Penn and Ohio State University.

## Key facts

- **NIH application ID:** 10413264
- **Project number:** 5R01DE026603-05
- **Recipient organization:** UNIVERSITY OF PENNSYLVANIA
- **Principal Investigator:** DANA T GRAVES
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $381,783
- **Award type:** 5
- **Project period:** 2018-08-07 → 2025-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10413264

## Citation

> US National Institutes of Health, RePORTER application 10413264, Diabetes reversal and the subgingival microbiota (5R01DE026603-05). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/10413264. Licensed CC0.

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