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Journals / Journal of Health Sciences and Medicine / 2026 / Volume: 9 Issue: 1

The bidirectional relationship between diabetes mellitus and periodontal disease

Diabetes mellitus ile periodontal hastalık arasındaki çift yönlü ilişki

Tuğba Şahin(BOLU ABANT İZZET BAYSAL ÜNİVERSİTESİ, DİŞ HEKİMLİĞİ FAKÜLTESİ)0000-0002-8133-9406
Alperen Çakır0009-0005-5658-0424
Ramazan Akbey0009-0004-8855-9155
Pages
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Publication Date
2026-01-05
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Enhancing collaboration between medical and dental experts can improve patient education, facilitate preventative care, and ultimately preserve both systemic and periodontal health.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Diabetes mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia due to defects in insulin secretion, insulin action, or both.
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Key Findings & Data:The bilateral association between DM and periodontal disease highlights the necessity for clinicians to incorporate periodontal evaluations into the standard care of diabetic patients.
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Conclusion & Impact:Enhancing collaboration between medical and dental experts can improve patient education, facilitate preventative care, and ultimately preserve both systemic and periodontal health.
🔬Design:Review & Systematic Survey
📍Scope:Comprehensive Sample
⚙️Variables:Diabetes mellitus · gingivitis · periodontitis

Abstract

Diabetes mellitus (DM) is a chronic metabolic disorder characterized by persistent hyperglycemia due to defects in insulin secretion, insulin action, or both. As a major global health concern, diabetes is associated with multiple systemic complications. In recent years, the bidirectional relationship between DM and periodontal diseases has gained increasing attention. This review aims to highlight the classification, pathophysiology, and complications of diabetes, while emphasizing the reciprocal interactions between DM and periodontal diseases. Moreover, the prevalence, pathogenesis, and clinical manifestations of periodontal diseases in diabetic individuals are discussed, along with dental treatment approaches tailored for these patients. The bilateral association between DM and periodontal disease highlights the necessity for clinicians to incorporate periodontal evaluations into the standard care of diabetic patients. Timely diagnosis, stringent glycemic management, and consistent periodontal treatment are critical measures to mitigate disease progression and enhance clinical results. Enhancing collaboration between medical and dental experts can improve patient education, facilitate preventative care, and ultimately preserve both systemic and periodontal health.

Özet

Diabetes mellitus (DM), insülin salgılanması, insülin etkisi veya her ikisindeki bozukluklara bağlı olarak ortaya çıkan ve sürekli hiperglisemi ile karakterize edilen kronik bir metabolik hastalıktır. Küresel ölçekte önemli bir sağlık sorunu olan diyabet, birçok sistemik komplikasyon ile ilişkilendirilmektedir. Son yıllarda, DM ile periodontal hastalıklar arasındaki çift yönlü ilişki giderek daha fazla dikkat çekmektedir. Bu derleme, diyabetin sınıflandırılması, patofizyolojisi ve komplikasyonlarını ele alırken aynı zamanda DM ile periodontal hastalıklar arasındaki karşılıklı etkileşimlere de vurgu yapmaktadır. Ayrıca, diyabetli bireylerde periodontal hastalıkların prevalansı, patogenezi ve klinik bulguları tartışılmakta ve bu hastalara yönelik dental tedavi yaklaşımları incelenmektedir. Diyabetin periodontal dokular üzerindeki etkilerinin anlaşılması, etkili bir diş hekimliği pratiği ve multidisipliner bir yaklaşımla kapsamlı hasta yönetimi için büyük önem taşımaktadır. Erken tanı, düzenli periodontal bakım ve sıkı glisemik kontrol, diyabetli bireylerde periodontal sağlığın korunmasında kritik rol oynamaktadır.

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Cite This Article

Şahin, T., Çakır, A., Akbey, R. (2026). The bidirectional relationship between diabetes mellitus and periodontal disease. Journal of Health Sciences and Medicine, Volume: 9 Issue: 1. https://doi.org/10.32322/jhsm.1795644

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References (63)

  1. Güvenç M, Diyabet. İksad Publishing House. Ankara: Türkiye; 2024. p. 7. doi:10.5281/zenodo.13830550
  2. Pucher J, Stewart J. Periodontal disease and diabetes mellitus. Curr Diab Rep. 2004;4:46-50. doi:10.1007/s11892-004-0011-y
  3. Mealey BL, Oates TW. Diabetes mellitus and periodontal diseases. J Periodontol. 2006;77:1289-1303. doi:10.1902/jop.2006.050459
  4. Zhao D, Sun Y, Li X, et al. Association between periodontitis and HbA1c levels in non-diabetic patients: a systematic review and meta-analysis. Healthcare (Basel). 2023;11(19):2649. doi:10.3390/healthcare11192649
  5. Acıpınar Ş, Hendek MK, Erdemir EO. Periodontitis ve diabetes mellitus: çift yönlü ilişki. Kırıkkale Üniversitesi Tıp Fakültesi Dergisi. 2017;19:103-113. doi:10.24938/kutfd.321684
  6. Association AD. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014;37:81-90. doi:10.2337/dc14-S081
  7. Petersmann A, Müller-Wieland D, Müller UA, et al. Definition, classification and diagnosis of diabetes mellitus. Exp Clin Endocrinol Diabetes. 2019;127:1-7. doi:10.1055/a-1018-9078
  8. Rufo DD, Debelee TG, Ibenthal A, Negera WG. Diagnosis of diabetes mellitus using gradient boosting machine (LightGBM). Diagnostics. 2021;11(9):1714. doi:10.3390/diagnostics11091714
  9. Beyan H, Riese H, Hawa MI, et al. Glycotoxin and autoantibodies are additive environmentally determined predictors of type 1 diabetes: a twin and population study. Diabetes. 2012;61:1192-1198. doi:10.2337/db 11-0971
  10. Billings LK, Florez JC. The genetics of type 2 diabetes: what have we learned from GWAS? Ann N Y Acad Sci. 2010;1212:59-77. doi:10.1111/j.17 49-6632.2010.05838.x
  11. Khardori R. Type 2 diabetes mellitus. Medscape Diabetes & Endocrinology. 2013:1-98
  12. Vounzoulaki E, Khunti K, Abner SC, Tan BK, Davies MJ, Gillies CL. Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta-analysis. Bmj. 2020; 369:1-11. doi:10.1136/bmj.m1361
  13. Harreiter J, Roden M. Diabetes mellitus–definition, klassifikation, diagnose, screening und prävention (update 2023). Wiener Klinische Wochenschrift. 2023;135:7-17. doi:10.1007/s00508-022-02122-y
  14. Selvin E, Steffes MW, Gregg E, Brancati FL, Coresh J. Performance of A1C for the classification and prediction of diabetes. Diabetes Care. 2011;34:84-89. doi:10.2337/dc10-1235
  15. Magliano DJ, Boyko EJ. IDF diabetes atlas. Elsevier; 2022.
  16. Animaw W, Seyoum Y. Increasing prevalence of diabetes mellitus in a developing country and its related factors. PloS One. 2017;12:0187670. doi:10.1371/journal.pone.0187670
  17. Zimmet P, Alberti KG, Magliano DJ, Bennett PH. Diabetes mellitus statistics on prevalence and mortality: facts and fallacies. Nat Rev Endocrinol. 2016;12:616-622. doi:10.1038/nrendo.2016.105
  18. Coşansu G. Diyabet: küresel bir salgın hastalık. Okmeydanı Tıp Dergisi. 2015;31:1-6. doi:10.5222/otd.2015.001
  19. Goldacre M. Cause-specific mortality: understanding uncertain tips of the disease iceberg. J Epidemiol Community Health. 1993;47:491-496. doi:10.1136/jech.47.6.491
  20. Aune D, Schlesinger S, Neuenschwander M, et al. Diabetes mellitus, blood glucose and the risk of heart failure: a systematic review and meta-analysis of prospective studies. Nutr Metab Cardiovasc Dis. 2018; 28:1081-1091. doi:10.1016/j.numecd.2018.07.005
  21. Li S, Wang J, Zhang B, Li X, Liu Y. Diabetes mellitus and cause-specific mortality: a population-based study. Diabetes Metab J. 2019;43:319-341. doi:10.4093/dmj.2018.0060
  22. American Diabetes Association Professional Practice Committee. 6. Glycemic Goals and Hypoglycemia: Standards of Care in Diabetes-2025. Diabetes Care. 2025;48(1 Suppl 1):S128-S145. doi: 10.2337/dc25-S006
  23. Belting CM, Hiniker J, Dummett CO. Influence of diabetes mellitus on the severity of periodontal disease. J Periodontol. 1964;35:476-480. doi:10.1902/jop.1964.35.6.476
  24. Lloyd C, Nouwen A, Sartorius N, et al. Prevalence and correlates of depressive disorders in people with type 2 diabetes: results from the International Prevalence and Treatment of Diabetes and Depression (INTERPRET‐DD) study, a collaborative study carried out in 14 countries. Diabet Med. 2018;35:760-769. doi:10.1111/dme.13611
  25. Kavak F, Aktürk Ü. Diyabet hastalarında hastalık algısının anksiyete ve depresyon belirtileri üzerine etkisi. Acibadem Univ Saglik Bilim Derg. 2019:740-747. doi:10.31067/0.2019.224
  26. Caton JG, Armitage G, Berglundh T, et al. A new classification scheme for periodontal and peri‐implant diseases and conditions–introduction and key changes from the 1999 classification. In. vol. 89. Wiley Online Library. 2018:1-8. doi:10.1002/JPER.18-0157
  27. Murakami S, Mealey BL, Mariotti A, Chapple IL. Dental plaque–induced gingival conditions. J Clin Periodontol. 2018;45:17-27. doi:10.1111/jcpe. 12937
  28. Chapple IL, Mealey BL, Van Dyke TE, et al. Periodontal health and gingival diseases and conditions on an intact and a reduced periodontium: consensus report of workgroup 1 of the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions. J Periodontol. 2018;89:74-84. doi:10.1002/JPER.17-0719
  29. Cope G, Cope A. Gingivitis: symptoms, causes and treatment. Dental Nursing. 2011;7:436-439. doi:10.12968/denn.2011.7.8.436
  30. Holmstrup P, Plemons J, Meyle J. Non-plaque-induced gingival diseases. J Periodontol. 2018;89(1):28-45. doi:10.1002/JPER.17-0163
  31. Papapanou PN, Sanz M, Buduneli N, et al. Periodontitis: consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions. J Periodontol. 2018;89:173-182. doi:10.1002/JPER.17-0721
  32. Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: framework and proposal of a new classification and case definition. J Periodontol. 2018;89:159-172. doi:10.1002/JPER.18-0006
  33. Lalla E, Papapanou PN. Diabetes mellitus and periodontitis: A tale of two common interrelated diseases. Nat Rev Endocrinol. 2011; 7(12): 738-748. doi:10.1038/nrendo.2011.106
  34. Naguib G, Al-Mashat H, Desta T, Graves DT. Diabetes prolongs the inflammatory response to a bacterial stimulus through cytokine dysregulation. J Invest Dermatol. 2004;123(1):87-92. doi:10.1111/j.0022-202X.2004.22711.x
  35. Manouchehr-Pour M, Spagnuolo PJ, Rodman HM, Bissada NF. Impaired neutrophil chemotaxis in diabetic patients with severe periodontitis. J Dent Res. 1981; 60(3):729-30. doi:10.1177/00220345810600031101
  36. Mendes-Frias A, Viana da Costa A, Salazar F, Braga A, Silvestre R, Relvas M. Effect of type 1 diabetes on the inflammatory response in periodontal disease. Front Immunol. 2025;16:1683219. doi:10.3389/fimmu.2025.1683219
  37. Graves DT, Ding Z, Yang Y. The impact of diabetes on periodontal diseases. Periodontol. 2020;82:214-224. doi:10.1111/prd.12318
  38. Vlachou S, Loumé A, Giannopoulou C, Papathanasiou E, Zekeridou A. Investigating the interplay: periodontal disease and type 1 diabetes mellitus-a comprehensive review of clinical studies. Int J Mol Sci. 2024;25(13):7299. doi:10.3390/ijms25137299
  39. Ramasamy R, Yan SF, Schmidt AM. Receptor for AGE (RAGE): signaling mechanisms in the pathogenesis of diabetes and its complications. Ann N Y Acad Sci. 2011;1243:88-102. doi:10.1111/j.1749-6632.2011.06320.x
  40. Taylor JJ, Preshaw PM, Lalla E. A review of the evidence for pathogenic mechanisms that may link periodontitis and diabetes. J Clin Periodontol. 2013;40(14):113-134. doi:10.1111/jcpe.12059
  41. Bhatti JS, Sehrawat A, Mishra J, et al. Oxidative stress in the pathophysiology of type 2 diabetes and related complications: current therapeutics strategies and future perspectives. Free Radic Biol Med. (2022);184:114-134. doi:10. 1016/j.freeradbiomed.2022.03.019
  42. Pendyala G, Thomas B, Joshi SR. Evaluation of total antioxidant capacity of saliva in type 2 diabetic patients with and without periodontal disease: a case-control study. N Am J Med Sci. 2013;5(1): 51-7. doi:10.4103/1947-2714.106208
  43. Salvi GE, Kandylaki M, Troendle A, Persson GR, Lang NP. Experimental gingivitis in type 1 diabetics: a controlled clinical and microbiological study. J Clin Periodontol. 2005;32:310-316. doi:10.1111/j.1600-051X.2005. 00682.x
  44. Kıran M, Arpak N, Ünsal E, Erdoğan MF. The effect of improved periodontal health on metabolic control in type 2 diabetes mellitus. J Clin Periodontol. 2005;32:266-272. doi:10.1111/j.1600-051X.2005.00658.x
  45. Baez-Tlaxcalteco MS, Briceño-Ancona MS, Severino-Quintana E. Relación entre gingivitis e higiene oral con diabetes tipo 2. In. Conference Proceedings, Jornadas de Investigación en Odontología. 2022;2:22-26.
  46. Nagpal R, Yamashiro Y, Izumi Y. The two‐way association of periodontal infection with systemic disorders: an overview. Mediators Inflamm. 2015;2015(1):793898. doi:10.1155/2015/793898
  47. Grossi SG, Genco RJ. Periodontal disease and diabetes mellitus: a two‐way relationship. Ann Periodontol. 1998;3(1):51-61. doi:10.1902/annals. 1998.3.1.51
  48. Corbella S, Francetti L, Taschieri S, De Siena F, Fabbro MD. Effect of periodontal treatment on glycemic control of patients with diabetes: a systematic review and meta‐analysis. J Diabetes Investig. 2013;4(5):502-509. doi:10.1111/jdi.12088
  49. Molina CA, Ojeda LF, Jiménez MS, et al. Diabetes and periodontal diseases: an established two-way relationship. Int. J Diabetes Mellit. 2016;6(4):209-229.
  50. Wu C-z, Yuan Y-h, Liu H-h, et al. Epidemiologic relationship between periodontitis and type 2 diabetes mellitus. BMC Oral Health. 2020;20(1): 1-15. doi:10.1186/s12903-020-01180-w
  51. Zainal Abidin Z, Zainuren Z, Noor E, Mohd Nor N, Mohd Saffian S, Abdul Halim R. Periodontal health status of children and adolescents with diabetes mellitus: a systematic review and meta‐analysis. Aust Dent J. 2021;66(1):15-26. doi:10.1111/adj.12845
  52. Lappin DF, Robertson D, Hodge P, et al. The influence of glycated hemoglobin on the cross susceptibility between type 1 diabetes mellitus and periodontal disease. J Periodontol. 2015;86(11):1249-1259. doi:10. 1902/jop.2015.150149
  53. Tsai C, Hayes C, Taylor GW. Glycemic control of type 2 diabetes and severe periodontal disease in the US adult population. Community Dent Oral Epidemiol. 2002;30(3):182-192. doi:10.1034/j.1600-0528.2002. 300304.x
  54. Abariga SA, Whitcomb BW. Periodontitis and gestational diabetes mellitus: a systematic review and meta-analysis of observational studies. BMC Pregnancy and Childbirth. 2016;16(11):1-13. doi:10.1186/s12884-016-1145-z
  55. AlMutairi FF, Pani SC, Alrobaie FM, Ingle NA. Relationship between type-I diabetes mellitus and oral health status and oral health-related quality of life among children of Saudi Arabia. J Family Med Prim Care. 2020;9(2):647-651. doi:10.4103/jfmpc.jfmpc_1160_19
  56. Stöhr J, Barbaresko J, Neuenschwander M, Schlesinger S. Bidirectional association between periodontal disease and diabetes mellitus: a systematic review and meta-analysis of cohort studies. Sci Rep. 2021;11 (1):13686. doi:10.1038/s41598-021-93062-6
  57. Poudel P, Griffiths R, Wong VW, et al. Oral health knowledge, attitudes and care practices of people with diabetes: a systematic review. BMC Public Health. 2018;18(1):1-12. doi:10.1186/s12889-018-5485-7
  58. Kaur PK, Narula SC, Rajput R, Sharma RK, Tewari S. Periodontal and glycemic effects of nonsurgical periodontal therapy in patients with type 2 diabetes stratified by baseline HbA1c. J Oral Sci. 2015;57(3):201-211. doi:10.2334/josnusd.57.201
  59. Simpson TC, Clarkson JE, Worthington HV, et al. Treatment of periodontitis for glycaemic control in people with diabetes mellitus. Cochrane Database Syst Rev. 2022;4(4):Cd004714. doi:10.1002/14651858.CD004714.pub4
  60. Elnour MAA, Mirghani HO. Periodontitis treatment (surgical and nonsurgical) effects on glycemic control: a review and meta-analysis. Ann Afr Med. 2023;22(2):131-135. doi:10.4103/aam.aam_53_22
  61. Baeza M, Morales A, Cisterna C, et al. Effect of periodontal treatment in patients with periodontitis and diabetes: systematic review and meta-analysis. J Appl Oral Sci. 2020;28:1-13. doi:10.1590/1678-7757-2019-0248
  62. Hsu Y-J, Chen Y-H, Lin K-D, et al. Clinical outcomes and oral health-related quality of life after periodontal treatment with community health worker strategy in patients with type 2 diabetes: a randomized controlled study. Int J Environ Res Public Health. 2021;18(16):8371. doi:10.3390/ijerph18168371
  63. Bian Y, Liu C, Fu Z. Application value of combination therapy of periodontal curettage and root planing on moderate-to-severe chronic periodontitis in patients with type 2 diabetes. Head Face Med. 2021;17 (11):1-9. doi:10.1186/s13005-020-00253-z