Diabetes and the periodontium: The bi-directional relationship

An increased prevalence and severity of periodontitis is typically seen in diabetic patients especially in those with poor metabolic control.This has led to the designation of periodontal disease as the sixth complication of diabetes.The most significant change in uncontrolled diabetes is a reduction in the defence mechanism and increased susceptibility to infections, leading to destructive periodontal disease.The presence of a systemic infection causes insulin resistance, preventing glucose from entering the target cell.Presence of chronic gram-negative periodontal infections may also result in increased insulin resistance and poor glycemic control.