Severe periodontal disease often coexists with severe diabetes and the converse possibility that periodontal disease either predisposes or exacerbates the diabetic condition is in the forefront of current research. A link has been proposed that a rise in proinflammatory cytokines (proteins regulating the intensity and duration of the immune response) stimulates secretions from periodontopathic organisms that may amplify the impact on the metabolic state of the diabetic patient. This reaction can reduce glycemic control, affect insulin resistance and increase the risk of developing other diabetic complications.47
Studies suggest a plausible link on periodontitis to the affect and pathogenesis of systemic diseases through inflammatory changes that are elicited from the onset, fuelling a chronic infection especially where periodontal treatment is lacking.48 Researchers will continue seeking evidence to define the virulence and invasiveness of periodontal disease by its mechanism of putting stress on the body through spreading bacteria, increasing the inflammatory burden, or both.49
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