It has long been recognised that patients with type 2 diabetes mellitus (T2DM) tend to suffer from advanced forms of periodontal disease, particularly if they have poor glycaemic control. Many studies have reported T2DM to be a risk factor for periodontitis, with diabetic populations demonstrating increased gingival inflammation, probing depths, attachment loss and alveolar bone destruction compared with non-diabetic controls. T2DM is increasingly viewed as an inflammatory condition, and dysregulated immune-inflammatory responses in patients with T2DM may increase susceptibility to periodontal disease by disrupting local cytokine networks in the periodontium. Cytokines such as interleukin-6 (IL-6) and tumour necrosis factor-α (TNF-α) play a role in the pathogenesis of both diseases, and together with other mediators such as the IL-1 family of cytokines and adipokines may, in part, provide a mechanistic link between T2DM and periodontitis. Altered neutrophil function and deposition of advanced glycation endproducts (AGEs) are also likely to play key roles in increasing susceptibility to periodontitis in patients with T2DM. Emerging data have recently suggested that periodontal treatment may have a favourable impact on glycaemic control. Such findings, if confirmed, would present opportunities for the dental team to become increasingly involved in the general management of patients with both periodontal disease and T2DM.
Keywords: periodontal disease, risk factors, type 2 diabetes mellitus