title: "Diabetes and gum disease: the diabolic duo".
abstract: BACKGROUND
  Diabetes and periodontitis have long been linked in the dental literature but have never been substantiated. Periodontitis is an oral infection affecting the tooth-supporting tissues. Although the etiology for this condition is bacterial plaque, the host immune response may also mediate destruction of the periodontal tissues. Diabetes mellitus is intricately related to the development, progression and severity of periodontitis. The literature is abundant with studies depicting this association.
  
  
  CONCLUSIONS
  Diabetes mellitus (DM) is a complex disease with varying degrees of systemic and oral complications. The periodontium is also a target for diabetic damage. In recent years, a link between periodontitis and diabetes mellitus has been postulated. The present review highlights the relationship between diabetes mellitus and periodontitis. The potential mechanisms involved in the development of periodontitis in diabetic patients, influence of periodontitis on diabetes and the role of TNF-α, a prime inflammatory mediator linking both of them have been discussed.
  
  
  CONCLUSIONS
  Diabetes clearly increases the risk of periodontal diseases, and biologically plausible mechanisms have been demonstrated in abundance. Less clear is the impact of periodontal diseases on glycemic control of diabetes and the mechanisms through which this occurs. It is possible that periodontal diseases may serve as initiators or propagators of insulin resistance in a way similar to obesity, thereby aggravating glycemic control.
authors.affiliation: Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha 'O' Anusandhan University, Bhubaneswar, Orissa, India. Electronic address: dr_mks121@yahoo.co.in.
authors.forename: Manoj
authors.initials: M
authors.lastname: Kumar
authors.affiliation: Department of Conservative Dentistry and Endodontics, Institute of Dental Sciences, Siksha 'O' Anusandhan University, Bhubaneswar, Orissa, India.
authors.forename: Lora
authors.initials: L
authors.lastname: Mishra
authors.affiliation: Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha 'O' Anusandhan University, Bhubaneswar, Orissa, India.
authors.forename: Rinkee
authors.initials: R
authors.lastname: Mohanty
authors.affiliation: Department of Periodontics and Oral Implantology, Institute of Dental Sciences, Siksha 'O' Anusandhan University, Bhubaneswar, Orissa, India.
authors.forename: Rashmita
authors.initials: R
authors.lastname: Nayak
mesh_terms: D001786:Blood Glucose / Q000378:metabolism; D048909:Diabetes Complications / Q000276:immunology* / Q000473:pathology; D003922:Diabetes Mellitus, Type 1 / Q000276:immunology* / Q000382:microbiology; D003924:Diabetes Mellitus, Type 2 / Q000276:immunology* / Q000382:microbiology; D018450:Disease Progression; D005881:Gingiva / Q000382:microbiology; D017127:Glycation End Products, Advanced / Q000378:metabolism; D006801:Humans; D007249:Inflammation / Q000276:immunology* / Q000473:pathology; D007333:Insulin Resistance; D010518:Periodontitis / Q000276:immunology* / Q000473:pathology; D010519:Periodontium / Q000382:microbiology; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000276:immunology
chemical_list: D001786:Blood Glucose; D017127:Glycation End Products, Advanced; D014409:Tumor Necrosis Factor-alpha
keywords: Diabetes mellitus; Periodontitis; TNF-α