Insulin resistance (IR) is now considered as a chronic and low level inflammatory condition. It is closely related to altered glucose tolerance, hypertriglyceridemia, abdominal obesity, and coronary heart disease. IR is accompanied by the increase in the levels of inflammatory cytokines like interleukin-1 and 6, tumor necrosis factor-α. These inflammatory cytokines also play a crucial part in pathogenesis and progression of insulin resistance. Periodontitis is the commonest of oral diseases, affecting tooth investing tissues. Pro-inflammatory cytokines are released in the disease process of periodontitis. Periodontitis can be attributed with exacerbation of IR. Data in the literature supports a "two way relationship" between diabetes and periodontitis. Periodontitis is asymptomatic in the initial stages of disease process and it often escapes diagnosis. This review presents the blurred nexus between periodontitis and IR, underlining the pathophysiology of the insidious link. The knowledge of the association between periodontitis and IR can be valuable in planning effectual treatment modalities for subjects with altered glucose homeostasis and diabetics. Presently, the studies supporting this association are miniscule. Further studies are mandatory to substantiate the role of periodontitis in the deterioration of IR.

Citations

Citations to this article as recorded by  

• Recent Aspects of Periodontitis and Alzheimer’s Disease—A Narrative Review
  Dominika Cichońska, Magda Mazuś, Aida Kusiak
  International Journal of Molecular Sciences.2024; 25(5): 2612.     CrossRef
• Association of Chronic Periodontitis with Helicobacter pylori Infection in Stomach or Mouth: A Systematic Review and Meta-Analysis
  Athanasios Tsimpiris, Ioannis Tsolianos, Andreas Grigoriadis, Ioannis Moschos, Dimitrios G. Goulis, Georgios Kouklakis
  European Journal of Dentistry.2023; 17(02): 270.     CrossRef
• Bidirectional association between polycystic ovary syndrome and periodontal diseases
  Yang Dou, Jinglei Xin, Peng Zhou, Jianming Tang, Hongliang Xie, Wanting Fan, Zheng Zhang, Donglei Wu
  Frontiers in Endocrinology.2023;[Epub]     CrossRef
• Comparison of the triglyceride glucose index and modified triglyceride glucose indices in assessing periodontitis in Korean adults
  Hyun‐Jeong Lee, Ji‐Won Lee, Sue Kim, Yu‐Jin Kwon
  Journal of Periodontal Research.2023; 58(3): 503.     CrossRef
• Risk Assessment of Periodontitis according to Metabolic Score for Insulin Resistance in Korean Population: Korea National Health and Nutrition Examination Survey VI (2013–2015)
  In-Hwan Kim, Yea-Chan Lee, Yu-Jin Kwon, Yong-Jae Lee
  Korean Journal of Family Practice.2023; 13(1): 38.     CrossRef
• RELAÇÃO ENTRE OBESIDADE E DOENÇA PERIODONTAL: REVISÃO INTEGRATIVA
  Maria Eduarda Ribeiro Da Silva, Karina Sarno Paes Alves Dias, Pedro Gomes Fonseca Rocha, Paollo Teixeira de Amorim Santos, Matheus Feliphe Lima De Melo, Iago Fraga Araújo, Caio Santos Porto, Cícero Gabriel dos Santos Coutinho, Gledyson Sousa Caires
  REVISTA FOCO.2023; 16(6): e2257.     CrossRef
• Non-Insulin-Based Insulin Resistance Indices and Localized Periodontitis in Physically Active Young Male Adults: CHIEF Oral Health Study
  Kun-Zhe Tsai, Yen-Po Lin, Shiue-Wei Lai, Chia-Hsin Liu, Yun-Chen Chang, Gen-Min Lin
  Endocrine, Metabolic & Immune Disorders - Drug Targets.2023; 23(7): 937.     CrossRef
• Periodontal Disease and Its Association with Metabolic Syndrome—A Comprehensive Review
  Itay Aizenbud, Asaf Wilensky, Galit Almoznino
  International Journal of Molecular Sciences.2023; 24(16): 13011.     CrossRef
• Periodontitis is associated with insulin resistance in adults living with diabetes mellitus in Uganda: a cross- sectional study
  Haruna Muhmood Kiryowa, Ian Guyton Munabi, William Buwembo, Charles Mugisha Rwenyonyi, Erisa Sabakaki Mwaka, Mark Kaddumukasa
  BMC Research Notes.2023;[Epub]     CrossRef
• Periodontal and systemic health of morbidly obese patients eligible for bariatric surgery: a cross-sectional study
  Dejana Čolak, Alja Cmok Kučič, Tadeja Pintar, Boris Gašpirc, Rok Gašperšič
  BMC Oral Health.2022;[Epub]     CrossRef
• Impact of Periodontitis on Glycemic Control and Metabolic Status in Diabetes Patients: Current Knowledge on Early Disease Markers and Therapeutic Perspectives
  Simona Santonocito, Alessandro Polizzi, Enrico Marchetti, Domenico Dalessandri, Marco Migliorati, Saturnino Marco Lupi, Marco Cicciù, Gaetano Isola, Alessandro Trentini
  Mediators of Inflammation.2022; 2022: 1.     CrossRef
• Do Cytokines Associate Periodontitis with Metabolic Disorders? An Overview of Current Documents
  Reza Aref Nezhad, Hossein Motedayyen, Hossein Roghani-Shahraki
  Endocrine, Metabolic & Immune Disorders - Drug Targets.2022; 22(7): 778.     CrossRef
• Comparison of the triglyceride glucose (TyG) index, triglyceride to high-density lipoprotein cholesterol (TG/HDL-C) ratio, and metabolic score for insulin resistance (METS-IR) associated with periodontitis in Korean adults
  Yea-Chan Lee, Ji-Won Lee, Yu-Jin Kwon
  Therapeutic Advances in Chronic Disease.2022; 13: 204062232211226.     CrossRef
• Markers, pathways, and current evidence for periodontitis-associated insulin resistance: A narrative review
  VivekKumar Bains, Jaideep Mahendra, Little Mahendra, Madhukar Mittal, Gunam Valli
  Journal of International Society of Preventive and Community Dentistry.2022; 12(5): 475.     CrossRef
• Periodontal Therapy in Bariatric Surgery Patients with Periodontitis: Randomized Control Clinical Trial
  Dejana Čolak, Alja Cmok Kučič, Tadeja Pintar, Rok Gašperšič
  Journal of Clinical Medicine.2022; 11(22): 6837.     CrossRef
• Systemic Diseases and Biological Dental Implant Complications: A Narrative Review
  Luca Sbricoli, Elissar Bazzi, Edoardo Stellini, Christian Bacci
  Dentistry Journal.2022; 11(1): 10.     CrossRef
• Association Between Diabetic Retinopathy and Periodontitis—A Systematic Review
  María Olimpia Paz Alvarenga, Giza Hellen Nonato Miranda, Railson Oliveira Ferreira, Miki Taketomi Saito, Nathália Carolina Fernandes Fagundes, Lucianne Cople Maia, Rafael Rodrigues Lima
  Frontiers in Public Health.2021;[Epub]     CrossRef
• Why is exercise important to dentistry?
  Rishiniy Pushparatnam
  BDJ Team.2021; 8(2): 20.     CrossRef
• The role of Wnt pathway in obesity induced inflammation and diabetes: a review
  Bhabajyoti Das, Manas Das, Anuradha Kalita, Momita Rani Baro
  Journal of Diabetes & Metabolic Disorders.2021; 20(2): 1871.     CrossRef
• Association between obesity and chronic periodontitis
  Tsung-Po Chen, Hui-Chieh Yu, Tai-Hsin Lin, Yu-Hsun Wang, Yu-Chao Chang
  Medicine.2021; 100(41): e27506.     CrossRef
• Association Between Triglyceride-Glucose Index and Risk of Periodontitis: A Cross-Sectional Study
  Lili Li, Lu Li, Yi Zhou, Xu Chen, Yan Xu
  International Journal of General Medicine.2021; Volume 14: 9807.     CrossRef

• Antioxidant and Anti-Inflammatory Properties of Melatonin in Patients with Type 2 Diabetes Mellitus with Periodontal Disease Under Non-Surgical Periodontal Therapy: A Double-Blind, Placebo-Controlled Trial

  
  Ahmad Zare Javid, Seyed Ahmad Hosseini, Hassan Gholinezhad, Leila Moradi, Mohammad Hosein Haghighi-zadeh, Hadi Bazyar
  Diabetes, Metabolic Syndrome and Obesity: Targets and Therapy.2020; Volume 13: 753.     CrossRef
• Influence of non-surgical periodontal therapy on insulin resistance in chronic periodontitis subjects with prediabetes
  Shravani Babladi, Rupali Agnihotri, Pratibha Gopalkrishna, Shobha U. Kamath, Sushma Jogi, Brunda Arun
  International Journal of Diabetes in Developing Countries.2019; 39(2): 273.     CrossRef
• The relationship of diabetes, periodontitis and cardiovascular disease
  Anandhara Indriani Khumaedi, Dyah Purnamasari, Ika Prasetya Wijaya, Yuniarti Soeroso
  Diabetes & Metabolic Syndrome: Clinical Research & Reviews.2019; 13(2): 1675.     CrossRef
• Association between Regular Electronic Nicotine Product Use and Self-Reported Periodontal Disease Status: Population Assessment of Tobacco and Health Survey
  Nkiruka Atuegwu, Mario Perez, Cheryl Oncken, Sejal Thacker, Erin Mead, Eric Mortensen
  International Journal of Environmental Research and Public Health.2019; 16(7): 1263.     CrossRef
• Evaluation and comparison of serum vitamin D and calcium levels in periodontally healthy, chronic gingivitis and chronic periodontitis in patients with and without diabetes mellitus – a cross-sectional study
  Anshuka A. Agrawal, Abhay P. Kolte, Rajashri A. Kolte, Suresh Chari, Madhur Gupta, Resham Pakhmode
  Acta Odontologica Scandinavica.2019; 77(8): 592.     CrossRef
• Periodontal inflammation correlates with systemic inflammation and insulin resistance in patients with recent diagnosis of type 2 diabetes
  Natacha Oyarzo, María Riveros, Constanza Andaur, Jessica Liberona, Víctor Cortés
  ARS MEDICA Revista de Ciencias Médicas.2019; 44(1): 6.     CrossRef
• A longitudinal study on the relationship between dental health and metabolic syndrome in Japan
  Shin‐ichi Sakurai, Shin‐ichi Yamada, Imahito Karasawa, Akinari Sakurai, Hiroshi Kurita
  Journal of Periodontology.2019; 90(7): 728.     CrossRef
• Triglyceride to high density lipoprotein cholesterol ratio and its association with periodontal disease in Korean adults: findings based on the 2012–2014 Korean national health and nutrition examination survey
  Yu-Jin Kwon, Jeong-Won Park, Hyoung-Ji Lim, Yong-Jae Lee, Hye-Sun Lee, Jae-Yong Shim
  Clinical Oral Investigations.2018; 22(1): 515.     CrossRef
• Periodontal complications of hyperglycemia/diabetes mellitus: Epidemiologic complexity and clinical challenge
  Thomas Kocher, Jörgen König, Wenche Sylling Borgnakke, Christiane Pink, Peter Meisel
  Periodontology 2000.2018; 78(1): 59.     CrossRef
• Nanofibrous Spongy Microspheres To Distinctly Release miRNA and Growth Factors To Enrich Regulatory T Cells and Rescue Periodontal Bone Loss
  Zhongning Liu, Xin Chen, Zhanpeng Zhang, Xiaojin Zhang, Laura Saunders, Yongsheng Zhou, Peter X. Ma
  ACS Nano.2018; 12(10): 9785.     CrossRef
• The role of dental practitioners in addressing overweight and obesity among children: A scoping review of current interventions and strategies
  Amy R. Villarosa, David George, Lucie M. Ramjan, Ravi Srinivas, Ajesh George
  Obesity Research & Clinical Practice.2018; 12(5): 405.     CrossRef
• Periodontitis and prevalence of elevated aminotransferases in the Hispanic Community Health Study/Study of Latinos
  Aderonke A. Akinkugbe, A. Sidney Barritt, Jianwen Cai, Steven Offenbacher, Bharat Thyagarajan, Tasneem Khambaty, Richard Singer, Eric Kallwitz, Gerardo Heiss, Gary D. Slade
  Journal of Periodontology.2018; 89(8): 949.     CrossRef
• Association of circulating leptin and adiponectin with periodontitis: a systematic review and meta-analysis
  Junfei Zhu, Bin Guo, Xueqi Gan, Ling Zhang, Yuting He, Beilei Liu, Xin Chen, Suhan Zhang, Haiyang Yu
  BMC Oral Health.2017;[Epub]     CrossRef
• Normal Oral Flora and the Oral Ecosystem
  Lakshman Samaranayake, Victor H. Matsubara
  Dental Clinics of North America.2017; 61(2): 199.     CrossRef
• Involvement of insulin resistance in normoglycaemic obese patients with periodontitis: A cross‐sectional study
  Mayte Martinez‐Herrera, Francisco Javier Silvestre, Javier Silvestre‐Rangil, Celia Bañuls, Milagros Rocha, Antonio Hernández‐Mijares
  Journal of Clinical Periodontology.2017; 44(10): 981.     CrossRef
• The relationship between insulin resistance and periodontitis is not affected by Mediterranean diet in a Spanish population
  M. Pulido-Moran, P. Bullon, J.M. Morillo, M. Battino, J.L. Quiles, MCarmen Ramirez-Tortosa
  Archives of Oral Biology.2017; 77: 62.     CrossRef
• Periodontitis contributes to adipose tissue inflammation through the NF-B, JNK and ERK pathways to promote insulin resistance in a rat model
  Yanli Huang, Jin Zeng, Guoqing Chen, Xudong Xie, Weihua Guo, Weidong Tian
  Microbes and Infection.2016; 18(12): 804.     CrossRef
• Systemic Inflammatory Biomarkers and Their Association With Periodontal and Diabetes‐Related Factors in the Diabetes and Periodontal Therapy Trial, A Randomized Controlled Trial
  Maria L. Geisinger, Bryan S. Michalowicz, Wei Hou, Elinor Schoenfeld, Marie Gelato, Steven P. Engebretson, Michael S. Reddy, Leslie Hyman
  Journal of Periodontology.2016; 87(8): 900.     CrossRef
• Association of Periodontitis and Subsequent Depression
  Chih-Chao Hsu, Yi-Chao Hsu, Hsuan-Ju Chen, Che-Chen Lin, Kuang-Hsi Chang, Chang-Yin Lee, Lee-Won Chong, Chia-Hung Kao
  Medicine.2015; 94(51): e2347.     CrossRef
• Association between insulin resistance and periodontitis in Korean adults
  Sang Gyu Lim, Kyungdo Han, Hyun‐Ah Kim, Sung Woon Pyo, Young‐Sik Cho, Kyung‐Soo Kim, Hyeon Woo Yim, Won‐Chul Lee, Yong Gyu Park, Yong‐Moon Park
  Journal of Clinical Periodontology.2014; 41(2): 121.     CrossRef
• Effect of scaling and root planing combined with systemic doxycycline therapy on glycemic control in diabetes mellitus subjects with chronic generalized periodontitis: a clinical study
  Subodh P. Gaikwad, Abhijit N. Gurav, Abhijeet R. Shete, Hitesh M. Desarda
  Journal of Periodontal & Implant Science.2013; 43(2): 79.     CrossRef
• Diabetes Mellitus and Inflammation
  Eric Lontchi-Yimagou, Eugene Sobngwi, Tandi E. Matsha, Andre Pascal Kengne
  Current Diabetes Reports.2013; 13(3): 435.     CrossRef
• Bacterial Infection Increases Periodontal Bone Loss in Diabetic Rats through Enhanced Apoptosis
  Sandra Pacios, Oelisoa Andriankaja, Jun Kang, Maher Alnammary, Jason Bae, Beatriz de Brito Bezerra, Helen Schreiner, Daniel H. Fine, Dana T. Graves
  The American Journal of Pathology.2013; 183(6): 1928.     CrossRef