How are Diabetes and Gum Disease connected?

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The presence of dangerous oral bacteria triggers inflammatory mediators which activate the inflammatory response. This results in an increased blood glucose level. Diabetics with Periodontal Infection have a 6-fold worsening of glycemic control. Infection causes the release of stress hormones. This worsens insulin resistance, causing a bigger rise in glucose levels and impairing the body’s ability to use the glucose for energy.

In addition, diabetics with Periodontal Infection have hyper-responsive monocyte/macrophage cells resulting in increased inflammatory cytokines.  This elevation produces higher levels of TNF𝝰 in response to periodontal bacteria as compared to non-diabetics. Diabetics have decreased immune cell function, inhibiting adequate defense against periodontal bacteria.

FACT: Periodontal disease treatment can result in a 0.4% HbA1c level reduction.


  • HbA1c: HbA1c is a lab test that shows the average level of blood sugar (glucose) over the previous 3 months. It shows how well you are controlling your diabetes.
  • AGEs: Advanced Glycogen End-products are proteins or lipids that become glycated after exposure to sugars.
  • Inflammatory mediators: Cytokines (types of proteins) that regulate various inflammatory responses such as TNF𝝰 (Tumor Necrosis Factor alpha), and IL-6 (Interleukin 6).
  • CRPs: C-Reactive Protein tests measure levels of inflammation in the body.
  • TNF𝝰: Tumor Necrosis Factor-Alpha is a pro-inflammatory cytokine that can be produced by inflamed periodontal tissues

How can we reverse this process?

The good news is that a 1% reduction in  HBA1c level is associated with the following:

  • 21% reduction of deaths related to diabetes
  • 21% reduction of risk for diabetes-related illnesses
  • 14% reduction in heart attack
  • 37% reduction of microvascular infection

Periodontal disease treatment can result in a 0.4% reduction of HbA1c levels! Common forms of treatment options include scaling and root planing and periodontal trays.