Periodontitis and Type 2 Diabetes: Is Oxidative Stress the Mechanistic Link?

Abstract

Periodontitis is a common, chronic inflammatory disease initiated by bacteria which has an increased prevalence and severity in patients with type 2 diabetes. Recent studies indicate that the co-morbid presence of periodontitis can, in turn, adversely affect diabetic status and the treatment of periodontitis can lead to improved metabolic control in diabetes patients. Current evidence points to a bidirectional interrelationship between diabetes and inflammatory periodontitis. The importance of oxidative stress-inflammatory pathways in the pathogenesis of type 2 diabetes and periodontitis has recently received attention. Given the bidirectional relationship between these two conditions, this review discusses the potential synergistic interactions along the oxidative stress-inflammation axis common to both type 2 diabetes and periodontitis, and the implications of this relationship for diabetic patients.

A population-based study on the association between the intake of soft drinks and periodontal disease in Taiwanese adults aged 35–44 years (KCIS no. 33)

“…Having more inflammatory biomarker data would help us determine whether the association observed was mediated through inflammation. Some variables such as hyperglycaemia and BMI have been associated with inflammation in other studies (6,8,(13)(14)(15)(16)23,29) . The fact that the soft drink-PD relationship persisted after adjustment for these variables may in some part be due to them not accounting completely for inflammation, although there may well be other mechanisms as well.…”

“…For instance, glucose-containing carbonated soft drinks increase carbonyl stress burden (3) , which, in turn, may result in a decrease in antioxidant concentration in oral saliva (4) and enhance oxidative nitration in association with the inflammatory reaction (5) . From the biological viewpoint, the inflammatory reaction caused by such oxidative stress is highly associated with systemic diseases, such as metabolic syndrome, diabetes, hypertension, asthma and periodontal disease (PD) (6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16) . Oxidative stress (2,3,6,8,9,(13)(14)(15) pertaining to PD may be mediated through advanced glycation end-products that are created through non-enzymatic pathways from monosaccharide substances, dicarbonyls originating from the Maillard reaction, sugar self-oxidation and other molecular pathways (16,17) .…”

Effect of Non-Surgical Therapy on Salivary Nitric Oxide and Lipid Peroxidation Levels in Type Ii Diabetic and Non Diabetic Patients With Periodontal Disease

“…Existing evidence advocates that development of diabetic state may be due to oxidative stress which has occurred due to the underlying pathological condition and may also favor the development of diabetic complications. The stimulated inflammation noticed in the diabetic condition is a direct expression and result of chronic pre-existing oxidative stress [4].…”

Periodontitis in Patients with Type 2 Diabetes Mellitus

“…The oxidative stressinflammatory pathways common in both diseases show that the relationship between both diseases prove to be synergistic. [28] Shortened Leukocyte Telomere Length (LTL) and the diagnosis of Periodontitis both can induce a higher risk of Type 2 Diabetes. According to a recent study, Dental examinations characterized the levels of periodontitis and LTL was measured by PCR after DNA Extraction.…”