Diabetes mellitus and oral inflammatory diseases: clinical relevance of HbA1c level monitoring for the primary care physician

Cover Page


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

Diabetes mellitus (DM) and oral inflammatory diseases are common and exhibit a bidirectional pathogenetic relationship, which is clinically important for primary care physicians. Hyperglycemia initiates a cascade of pathological processes, including endothelial dysfunction, accumulation of advanced glycation end products, oxidative stress, dysbiosis, and a hyperinflammatory immune response. These factors contribute to the higher rates of periodontitis (43.7% vs. 25%), candidiasis, and xerostomia in patients with DM. HbA1c is a modifiable risk factor: levels >8% are associated with increased risk of severe periodontitis and qualitative changes in the oral microbiota, whereas levels < 7% reduce dental complication rates to a level comparable to that patients without confirmed DM. Treatment of periodontitis contributes to improved glycemic control (HbA1c reduction by 0.48%–0.53%), corroborating the concept of a bidirectional relationship. Nevertheless, dental screening by primary care physicians is infrequent: only 5.7% routinely take a dental history, and 12.1% refer patients to a dentist.

This review synthesizes data on the pathogenetic mechanisms underlying the relationship between DM and oral inflammatory diseases, examines the role of HbA1c as a predictor of dental complications, and offers practical outpatient screening and referral recommendations. Regular flossing reduces the risk of periodontitis by 39% and lowers HbA1c by 0.30%, thereby confirming the potential for preventing dental complications in patients with DM. Promising directions include the development of standardized interdisciplinary protocols and training programs on oral examination for general practitioners, and integration of screening tools into primary care and dental practice. A comprehensive approach would shift care from isolated parameter monitoring to effective interdisciplinary DM management.

Full Text

Restricted Access

About the authors

Angelina R. Akhmaletdinova

Bashkir State Medical University

Email: gelya.gelya.00@bk.ru
ORCID iD: 0009-0007-4627-4727
Russian Federation, Ufa

Aliya A. Yakupova

Bashkir State Medical University

Email: yakupova030303@gmail.com
ORCID iD: 0009-0003-3864-4258
Russian Federation, Ufa

Alyona A. Slepova

Pavlov First Saint Petersburg State Medical University

Email: hatpostas@mail.ru
ORCID iD: 0009-0008-9492-8948
Russian Federation, Saint Petersburg

Daria V. Chobanu

Saint Petersburg State University

Email: misstyukk@gmail.com
ORCID iD: 0009-0004-0290-4625
Russian Federation, Saint Petersburg

Valeriya D. Iakovleva

Saint Petersburg State University

Email: yakovleva1600@mail.ru
ORCID iD: 0009-0008-9968-935X
Russian Federation, Saint Petersburg

Elena A. Chumachenko

Saint Petersburg State Pediatric Medical University

Email: Ogneva-ri@rambler.ru
ORCID iD: 0009-0005-6447-4875
Russian Federation, Saint Petersburg

Elizaveta N. Basharina

Saint Petersburg State University

Email: kodokushhii@gmail.com
ORCID iD: 0009-0003-7473-4699
Russian Federation, Saint Petersburg

Valeria M. Ibragimova

Pavlov First Saint Petersburg State Medical University

Email: Kalliostra1@gmail.com
ORCID iD: 0009-0007-0134-9094
Russian Federation, Saint Petersburg

Anastasia S. Kravtsova

Pavlov First Saint Petersburg State Medical University

Email: nastyarevda2003@mail.ru
ORCID iD: 0009-0006-0681-9094
Russian Federation, Saint Petersburg

Aminat B. Atieva

Pavlov First Saint Petersburg State Medical University

Email: atieva2411@mail.ru
ORCID iD: 0009-0004-9577-0485
Russian Federation, Saint Petersburg

Elina I. Musaeva

Pavlov First Saint Petersburg State Medical University

Email: elina041214@icloud.com
ORCID iD: 0009-0003-6525-4650
Russian Federation, Saint Petersburg

Veronika Yu. Nikonova

Voronezh State Medical University named after N.N. Burdenko

Email: Sinelnikova68tmb@mail.ru
ORCID iD: 0009-0000-3793-5502
Russian Federation, Voronezh

Karina E. Valeeva

Izhevsk State Medical University

Email: karina.valeevaa@mail.ru
ORCID iD: 0009-0004-9142-6417
Russian Federation, Izhevsk

Kristina E. Vladimirova

Bashkir State Medical University

Author for correspondence.
Email: kgorshkove@bk.ru
ORCID iD: 0009-0007-9222-1247
Russian Federation, Ufa

References

  1. Tuleutaeva ST, Ashirbekova ZZ, Ponamareva OA, Granko SA. Diabetes mellitus and chronic periodontitis: a bidirectional relationship. Bulletin of the Karaganda University. Biology. Medicine. Geography Series. 2021;104(4):117–121. doi: 10.31489/2021BMG4/117–121 EDN: EMJGDF
  2. Kafarov RT, Medzhidov MN, Vasilyev OS, et al. Epidemiological characteristics of diabetes mellitus in patients with chronic generalized periodontitis. Modern Issues of Biomedicine. 2026;10(1(36)):226–236. doi: 10.24412/2588-0500-2026_10_01_26
  3. Chen YaF, Zhan Q, Wu ChZh, et al. Baseline HbA1c level influences the effect of periodontal therapy on glycemic control in people with type 2 diabetes and periodontitis: a systematic review on randomized controlled trails. Diabetes Ther. 2021;12(5):1249–1278. doi: 10.1007/s13300-021-01000-6 EDN: CWSHYA
  4. Anton DM, Martu MA, Maris M, et al. Study on the effects of melatonin on glycemic control and periodontal parameters in patients with type II diabetes mellitus and periodontal disease. Medicina. 2021;57(2):140. doi: 10.3390/medicina57020140 EDN: PYWMON
  5. Slazhneva ES, Atrushkevich VG, Orekhova LYu, Loboda ES. Prevalence of periodontal diseases in patients with different body mass index. Parodontologiya. 2022;27(3):202–208. doi: 10.33925/1683-3759-2022-27-3-202-208 EDN: KLPVCI
  6. Brinar S, Skvarča A, Gašpirc B, Schara R. The effect of antimicrobial photodynamic therapy on periodontal disease and glycemic control in patients with type 2 diabetes mellitus. Clin Oral Investig. 2023;27(10):6235–6244. doi: 10.1007/s00784-023-05239-0 EDN: UTIFUB
  7. Costa R, Ríos-Carrasco B, Monteiro L, et al. Association between type 1 diabetes mellitus and periodontal diseases. J Clin Med. 2023;12(3):1147. doi: 10.3390/jcm12031147 EDN: MAYSDZ
  8. Yang Y, Sun X, Yang Yu, Qie Y. Insight of the interrelationship and association mechanism between periodontitis and diabetes mellitus. Regen Ther. 2024;26:1159–1167. doi: 10.1016/j.reth.2024.11.001 EDN: SOFAXS
  9. Gaisina EF, Przhevalskii YaA. Assessment of pathogenetic mechanisms and the influence of periodontal therapy on diabetes mellitus compensation. The Siberian Scientific Medical Journal. 2025;45(6):52–59. doi: 10.18699/SSMJ20250605 EDN: QELUJR
  10. Chien WC, Fu E, Chung CH, et al. Type 2 diabetes mellitus and periodontitis: bidirectional association in population-based 15-year retrospective cohorts. J Clin Endocrinol Metab. 2023;108(11):e1289–e1297. doi: 10.1210/clinem/dgad287 EDN: NTMFVG
  11. Abdul Aziz AF, Mohd-Dom TN, Mustafa N, et al. Screening for type 2 diabetes and periodontitis patients (CODAPT-My©): a multidisciplinary care approach. BMC Health Serv Res. 2022;22:1034. doi: 10.1186/s12913-022-08429-w EDN: IZJQYE
  12. Nordin NN, Vaithilingam RD, Saub R, et al. Awareness, knowledge, attitudes and practices on the management of diabetes mellitus patients with periodontitis amongst Malaysian primary care practitioners. Malays Fam Physician. 2021;16(3):44–55. doi: 10.51866/oa1131 EDN: MUEEOH
  13. Chatzaki N, Zekeridou A, Paroz E, et al. Knowledge and practice attitudes regarding the relationship between diabetes and periodontitis: a survey among Swiss endocrinologists and general physicians. BMC Prim Care. 2023;24(1):238. doi: 10.1186/s12875-023-02184-5 EDN: UUKYMH
  14. Vlachou S, Loumé A, Giannopoulou C, et al. Investigating the interplay: periodontal disease and type 1 diabetes mellitus—a comprehensive review of clinical studies. Int J Mol Sci. 2024;25(13):7299. doi: 10.3390/ijms25137299 EDN: NKRIPT
  15. Kumari S, Gnanasundaram N. Oral manifestations in diabetes mellitus: a review. J Indian Acad Oral Med Radiol. 2021;33(4):352–356. doi: 10.4103/jiaomr.jiaomr_325_21 EDN: FDZDJP
  16. Rohani B. Oral manifestations in patients with diabetes mellitus. World J Diabetes. 2019;10(9):485–489. doi: 10.4239/wjd.v10.i9.485
  17. Petrova TG, Borodina NB, Rymar SD, Rymar OD. The interaction of the dentist with an endocrinologist—a team approach in the treatment of inflammatory periodontal diseases in patients with type 2 diabetes mellitus (literature review). Parodontologiya. 2019;24(2):140–144. doi: 10.33925/1683-3759-2019-24-2-140-144 EDN: TTTCQX
  18. Martorano-Fernandes L, Dornelas-Figueira LM, Marcello-Machado RM, et al. Oral candidiasis and denture stomatitis in diabetic patients: systematic review and meta-analysis. Braz Oral Res. 2020;34:e113. doi: 10.1590/1807-3107bor-2020.vol34.0113 EDN: BQMJOR
  19. Rodríguez-Archilla A, Piedra-Rosales C. Candida species oral detection and infection in patients with diabetes mellitus: a meta-analysis. Iberoam J Med. 2021;3(2):115–121. doi: 10.53986/ibjm.2021.0020 EDN: VQNBYV
  20. Hong M, Kim HY, Seok H, et al. Prevalence and risk factors of periodontitis among adults with or without diabetes mellitus. Korean J Intern Med. 2016;31(5):910–919. doi: 10.3904/kjim.2016.031
  21. Wu CZ, Yuan YH, Liu HH, et al. Epidemiologic relationship between periodontitis and type 2 diabetes mellitus. BMC Oral Health. 2020;20(1):204. doi: 10.1186/s12903-020-01180-w
  22. Ojehanon PI, Azodo CC, Erhabor P, Orhue VE. Periodontal characteristics of diabetic patients with tooth mobility. J Soc Health Diabetes. 2017;5(2):94–99. doi: 10.1055/s-0038-1676247
  23. Sun KT, Chen SC, Lin CL, et al. The association between type 1 diabetes mellitus and periodontal diseases. J Formos Med Assoc. 2019;118(6):1047–1054. doi: 10.1016/j.jfma.2018.10.012
  24. Perić M, Miličić B, Kuzmanović Pfićer J, et al. A systematic review of denture stomatitis: predisposing factors, clinical features, etiology, and global Candida spp. distribution. J Fungi. 2024;10(5):328. doi: 10.3390/jof10050328 EDN: SIUISE
  25. McReynolds DE, Moorthy A, Moneley JOC, et al. Denture stomatitis-an interdisciplinary clinical review. J Prosthodont. 2023;32(7):560–570. doi: 10.1111/jopr.13687 EDN: EUDNGE
  26. Shafia A. Multisymptom oral presentation in type II diabetes mellitus: a case of candidiasis, xerostomia, and burning mouth syndrome. Al Makki HIJ. 2025;3(5):254–271. doi: 10.57185/sbrbap90
  27. Salman RA, Al-Ghurabi BH. The role of advanced glycation end products in the pathogenesis of diabetes-associated periodontitis. Dent 3000. 2026;14(1). doi: 10.5195/d3000/2026.1131
  28. Triebl Z, Bencze B, Bányai D, et al. Poor glycemic control impairs oral health in children with type 1 diabetes mellitus: a systematic review and meta-analysis. BMC Oral Health. 2024;24(1):748. doi: 10.1186/s12903-024-04516-y EDN: OQWWKN
  29. Chopra A, Jayasinghe TN, Eberhard J. Are inflamed periodontal tissues endogenous source of advanced glycation end-products (AGEs) in individuals with and without diabetes mellitus? A systematic review. Biomolecules. 2022;12(5):642. doi: 10.3390/biom12050642 EDN: HFYCEB
  30. Sharonova LA, Bulgakova SV, Burakshaev SA, et al. Relationship between the main components of metabolic syndrome and oral diseases. Experimental and Clinical Gastroenterology Journal. 2024;(8(228)):131–142. doi: 10.31146/1682-8658-ecg-228-8-131-142 EDN: SGHVSP
  31. Shevchenko EA, Potemina TE, Ivanova EG. Hemostasis disorder as a reason of periodontitis in patients with diabetes mellitus. Bulletin of the Medical Institute REAVIZ (Rehabilitation, Doctor, and Health). 2022;(2(56)):98–103. doi: 10.20340/vmi-rvz.2022.1.CLIN.4 EDN: IIMKOW
  32. Takeda K, Mizutani K, Mikami R, et al. Morphological analysis of the impact of diabetes on gingival capillaries with non-invasive blood flow scope: a preliminary study. J Dent Sci. 2023;18(3):1134–1140. doi: 10.1016/j.jds.2022.10.024 EDN: PQHCLF
  33. Nardi GM, Ferrara E, Converti I, et al. Does diabetes induce the vascular endothelial growth factor (VEGF) expression in periodontal tissues? A systematic review. Int J Environ Res Public Health. 2020;17(8):2765. doi: 10.3390/ijerph17082765 EDN: CYKWJW
  34. Chang YH, Huang CL, Hsieh AT, et al. Expression of advanced glycation end products and receptors in gingival tissues of patients with noninsulin-dependent diabetes mellitus-associated periodontitis. J Dent Sci. 2023;18(2):689–695. doi: 10.1016/j.jds.2022.10.019 EDN: JIJOJK
  35. Li DX, Deng TZ, Lv J, Ke J. Advanced glycation end products (AGEs) and their receptor (RAGE) induce apoptosis of periodontal ligament fibroblasts. Braz J Med Biol Res. 2014;47(12):1036–1043. doi: 10.1590/1414-431X20143996
  36. Settem RP, Sharma A. Oral bacterium contributes to periodontal inflammation by forming advanced glycation end products. Infect Immun. 2025;93(5):e00560-24. doi: 10.1128/iai.00560-24 EDN: KWTHCY
  37. Monea A, Mezei T, Popsor S, Monea M. Oxidative stress: a link between diabetes mellitus and periodontal disease. Int J Endocrinol. 2014;2014:917631. doi: 10.1155/2014/917631
  38. Patil VS, Patil VP, Gokhale N, et al. Chronic periodontitis in type 2 diabetes mellitus: oxidative stress as a common factor in periodontal tissue injury. J Clin Diagn Res. 2016;10(4):BC12–BC16. doi: 10.7860/JCDR/2016/17350.7542
  39. Gürsoy UK, Yilmaz N, Yilmaz D, et al. Type 1 diabetes mellitus and host-bacterial interactions in the oral cavity. Curr Opin Endocr Metab Res. 2024;36:100536. doi: 10.1016/j.coemr.2024.100536 EDN: PBPKTY
  40. Mesia R, Gholami F, Huang H, et al. Systemic inflammatory responses in patients with type 2 diabetes with chronic periodontitis. BMJ Open Diabetes Res Care. 2016;4(1):e000260. doi: 10.1136/bmjdrc-2016-000260
  41. Cai Z, Du S, Zhao N, et al. Periodontitis promotes the progression of diabetes mellitus by enhancing autophagy. Heliyon. 2024;10(2):e24366. doi: 10.1016/j.heliyon.2024.e24366 EDN: TDGXFR
  42. Arreguin-Cano JA, Ayerdi-Nájera B, Tacuba-Saavedra A, et al. MMP-2 salivary activity in type 2 diabetes mellitus patients. Diabetol Metab Syndr. 2019;11:113. doi: 10.1186/s13098-019-0510-2 EDN: VAJJHH
  43. Abduvakilov ZhU. Dental status of periodontal tissues in patients with metabolic syndrome. Journal of Biomedicine and Practice. 2018;(1):6–12. (In Russ.) doi: 10.26739/2181-9300-2017-1-1
  44. Li Y, Qian F, Cheng X, et al. Dysbiosis of oral microbiota and metabolite profiles associated with type 2 diabetes mellitus. Microbiol Spectr. 2023;11(1):e0379622. doi: 10.1128/spectrum.03796-22 EDN: WNKYSY
  45. Carelli M, Maguolo A, Zusi C, et al. Oral microbiota in children and adolescents with type 1 diabetes mellitus: novel insights into the pathogenesis of dental and periodontal disease. Microorganisms. 2023;11(3):668. doi: 10.3390/microorganisms11030668 EDN: BFSIQH
  46. Guo XJ, Dai SX, Lou JD, et al. Distribution characteristics of oral microbiota and its relationship with intestinal microbiota in patients with type 2 diabetes mellitus. Front Endocrinol. 2023;14:1119201. doi: 10.3389/fendo.2023.1119201 EDN: WSMVMA
  47. Zeng X, Huang S, Ye X, et al. Impact of HbA1c control and type 2 diabetes mellitus exposure on the oral microbiome profile in the elderly population. J Oral Microbiol. 2024;16(1). doi: 10.1080/20002297.2024.2345942 EDN: XZFJBR
  48. Almeida-Santos A, Martins-Mendes D, Gayà-Vidal M, et al. Characterization of the oral microbiome of medicated type-2 diabetes patients. Front Microbiol. 2021;12:610370. doi: 10.3389/fmicb.2021.610370 EDN: FGZCMC
  49. Gu M, Ge J, Pan Q, et al. Salivary microbiome variations in type 2 diabetes mellitus patients with different stages of periodontitis. BMC Oral Health. 2024;24(1):1424. doi: 10.1186/s12903-024-05135-3 EDN: GBMARO
  50. Tam J, Hoffmann T, Fischer S, et al. Obesity alters composition and diversity of the oral microbiota in patients with type 2 diabetes mellitus independently of glycemic control. PLoS One. 2018;13(10):e0204724. doi: 10.1371/journal.pone.0204724
  51. Jindal A, Parihar AS, Sood M, et al. Relationship between severity of periodontal disease and control of diabetes (glycated hemoglobin) in patients with type 1 diabetes mellitus. J Int Oral Health. 2015;7(Suppl 2):17–20.
  52. Pranckeviciene A, Siudikiene J, Ostrauskas R, Machiulskiene V. Severity of periodontal disease in adult patients with diabetes mellitus in relation to the type of diabetes. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2014;158(1):117–123. doi: 10.5507/bp.2013.098
  53. Du Y, Xiao H, Luo R, et al. The role of HbA1c in the bidirectional relationship between periodontitis and diabetes and related interventions: a narrative review. Front Nutr. 2025;12:1606223. doi: 10.3389/fnut.2025.1606223 EDN: RRWGYZ
  54. Kudiyirickal MG, Pappachan JM. Periodontitis: an often-neglected complication of diabetes. World J Diabetes. 2024;15(3):318–325. doi: 10.4239/wjd.v15.i3.318
  55. Banjar A, Alyafi R, AlGhamdi A, et al. The relationship between glycated hemoglobin level and the stage of periodontitis in individuals without diabetes. PLoS One. 2023;18(1):e0279755. doi: 10.1371/journal.pone.0279755 EDN: JENMNL
  56. Miranda TS, Feres M, Retamal-Valdes B, et al. Influence of glycemic control on the levels of subgingival periodontal pathogens in patients with generalized chronic periodontitis and type 2 diabetes. J Appl Oral Sci. 2017;25(1):82–89. doi: 10.1590/1678-77572016-0302
  57. Zhao D, Sun Y, Li X, et al. Association between periodontitis and HbA1c levels in non-diabetic patients: a systematic review and meta-analysis. Healthcare. 2023;11(19):2649. doi: 10.3390/healthcare11192649 EDN: VJTPLQ
  58. Orekhova LYu, Aleksandrova AA, Aleksandrova LA, et al. Oral conditions in pregnant women with different types of diabetes mellitus: clinical and cytological characteristics. Journal of Obstetrics and Womans Diseases. 2016;65(6):45–51. doi: 10.17816/JOWD65645-51 EDN: XEAHYL
  59. Orekhova LYu, Aleksandrova AA, Silina ES, et al. Periodontal status and effectiveness of an individual oral hygiene complex in the prevention of inflammatory periodontal diseases in pregnant women with diabetes mellitus. Parodontologiya. 2015;20(4(77)):33–39. (In Russ.) EDN: VOOCNF
  60. Mauri-Obradors E, Estrugo-Devesa A, Jané-Salas E, et al. Oral manifestations of diabetes mellitus: a systematic review. Med Oral Patol Oral Cir Bucal. 2017;22(5):e586–e594. doi: 10.4317/medoral.21655
  61. Sabirova AI. Modifiable risk factors for the development and progression of periodontal tissue diseases. Acta Biomedica Scientifica. 2022;7(5–2):182–192. doi: 10.29413/ABS.2022-7.5-2.19 EDN: DSATVK
  62. Verhulst MJ, Teeuw WJ, Gerdes VEA, Loos BG. Self-reported oral health and quality of life in patients with type 2 diabetes mellitus in primary care: a multi-center cross-sectional study. Diabetes Metab Syndr Obes. 2019;12:883–899. doi: 10.2147/DMSO.S207087
  63. Poudel P, Griffiths R, Wong VW, et al. Perceptions and practices of general practitioners on providing oral health care to people with diabetes: a qualitative study. BMC Fam Pract. 2020;21(1):1–11. doi: 10.1186/s12875-020-1102-9 EDN: ABVUBG
  64. Tse SYe. Diabetes mellitus and periodontal disease: awareness and practice among doctors working in public general out-patient clinics in Kowloon West Cluster of Hong Kong. BMC Fam Pract. 2018;19(1):1–9. doi: 10.1186/s12875-018-0887-2 EDN: LURNHV
  65. Obulareddy VT, Nagarakanti S, Chava VK. Knowledge, attitudes, and practice behaviors of medical specialists for the relationship between diabetes and periodontal disease: a questionnaire survey. J Family Med Prim Care. 2018;7(1):175–178. doi: 10.4103/jfmpc.jfmpc_425_16
  66. Alghazaly F, Hariyani N, Setyowati D, et al. Impacts of diabetes mellitus oral manifestation on quality of life: a systematic review. J Int Oral Health. 2024;16(6):421–431. doi: 10.4103/jioh.jioh_48_24 EDN: KHPCQP
  67. Mohamad N, Hui GP, Ahmad WMAW, Yudin ZM. Oral symptoms and oral health-related quality of life among Malaysian patients with diabetes mellitus. Pesqui Bras em Odontopediatria Clín Integr. 2025;25:e240081. doi: 10.1590/pboci.2025.023 EDN: NRCEOD
  68. Kuleshova EV, Khomyakova EV, Boguta YuA. Dental health of patients with diabetes mellitus. Vestnik of the Smolensk State Medical Academy. 2019;18(2):155–159. EDN: WKZQFV
  69. Lau P, Tran A, Chen M, et al. Interprofessional diabetes and oral health management: what do primary healthcare professionals think? F1000Research. 2021;10:339. doi: 10.12688/f1000research.52297.1 EDN: VFQOBM
  70. Schmalz G, Wolf C, Merle C, et al. Evaluation of a questionnaire-based diabetes screening concept in German patients with stage III or IV periodontitis: a practice-based study. J Periodontol. 2021;92(8):1163–1170. doi: 10.1002/JPER.20-0297 EDN: LXWTSN
  71. Tandon V, Tangade P, Lingesha RT, et al. Glycemic control and periodontal disease in type 2 diabetes mellitus patients: a cross-sectional study. J Indian Assoc Public Health Dent. 2015;13(3):297–301. doi: 10.4103/2319-5932.165279
  72. Carneiro VL, Fraiz FC, Ferreira FDM, et al. The influence of glycemic control on the oral health of children and adolescents with diabetes mellitus type 1. Arch Endocrinol Metab. 2015;59(6):535–540. doi: 10.1590/2359-3997000000117
  73. Hsu YJ, Lin KD, Chen JH, et al. Periodontal treatment experience associated with oral health-related quality of life in patients with poor glycemic control in type 2 diabetes: a case-control study. Int J Environ Res Public Health. 2019;16(20):4011. doi: 10.3390/ijerph16204011
  74. Zhang Y, Leveille SG, Camhi SM, Shi L. Association of oral care with periodontitis and glycemic control among US adults with diabetes. BMC Oral Health. 2023;23(1):903. doi: 10.1186/s12903-023-03580-0 EDN: LPXOMS
  75. Kaur PK, Narula SC, Rajput R, et al. Periodontal and glycemic effects of nonsurgical periodontal therapy in patients with type 2 diabetes stratified by baseline HbA1c. J Oral Sci. 2015;57(3):201–211. doi: 10.2334/josnusd.57.201
  76. Teshome A, Yitayeh A. The effect of periodontal therapy on glycemic control and fasting plasma glucose level in type 2 diabetic patients: systematic review and meta-analysis. BMC Oral Health. 2016;17:31. doi: 10.1186/s12903-016-0249-1 EDN: YIKAZY
  77. Mizuno H, Ekuni D, Maruyama T, et al. The effects of non-surgical periodontal treatment on glycemic control, oxidative stress balance and quality of life in patients with type 2 diabetes: a randomized clinical trial. PLoS One. 2017;12(11):e0188171. doi: 10.1371/journal.pone.0188171
  78. Rapone B, Ferrara E, Corsalini M, et al. The effect of gaseous ozone therapy in conjunction with periodontal treatment on glycated hemoglobin level in subjects with type 2 diabetes mellitus: an unmasked randomized controlled trial. Int J Environ Res Public Health. 2020;17(15):5467. doi: 10.3390/ijerph17155467 EDN: JXFIKV
  79. Stepanova AI, Gontarev SN, Gontareva IS. Alkaline phosphatase of saliva as a noninvasive marker of periodontal diseases in children with uncontrolled type 1 diabetes mellitus. Journal of New Medical Technologies. 2025;32(2):17–22. doi: 10.24412/1609-2163-2025-2-17-22 EDN: HCJUYJ
  80. Zhang Y, Chen Y, Wang C, et al. Community interventions improve diabetes management and oral health in type 2 diabetes patients with chronic periodontitis. Sci Rep. 2025;15(1):24395. doi: 10.1038/s41598-025-09034-7 EDN: XKHDMC

Supplementary files

Supplementary Files
Action
1. JATS XML
Download
2. Fig. 1. Dose-dependent effect of HbA1c on periodontitis risk.

Download (46KB)
Indexing metadata

Copyright (c) 2026 Eco-Vector

License URL: https://eco-vector.com/for_authors.php#07
СМИ зарегистрировано Федеральной службой по надзору в сфере связи, информационных технологий и массовых коммуникаций (Роскомнадзор).
Регистрационный номер и дата принятия решения о регистрации СМИ: серия ПИ № ФС 77 - 70763 от 21.08.2017 г.