People with diabetes, especially uncontrolled diabetes, have more of gum disease than those without diabetes due to reduced resistance to infection right?

We have known that for a long time. Isn't it? Now, its other way!

Scientifically its proven that gum disease may raise blood sugar levels in people with and without diabetes.

Scientists say that some of the germs in infected gums leak into the bloodstream.

This starts a reaction from your body’s defense system, which, in turn, produces some powerful molecules that cause insulin resistance raising your blood sugar level. (I can explain this at length-signal transduction pathways)

It's now said that Gum/Periodontal treatment help control YOUR diabetes!!

Yes,!! people with type 2 diabetes, treatment of severe disease (for instance, deep cleaning of their gums) can lead to a drop in blood sugar levels.

The benefit is about the same as you might find if you added another drug to your usual diabetes medicine.

Endocrinologists need to make patients understand that good dental care is very important and encourage good and aggressive oral hygiene.

This reverse causation would imply that endocrinologists, diabetologists would need to refer their patients more often to their Dentist/Periodontist, before finalizing their therapeutic approaches/doses, given that treating periodontal disease may favorably affect the control of diabetes.

One hypothesis linking clinical periodontal disease and incident type 2 diabetes involves chronic inflammation resulting from the bacterial infections that often contribute to clinical periodontal diseases.

“It is possible that these bacterial infections contribute to chronic elevations in systemic inflammatory mediators (ie, tumor necrosis factor-alpha).

Studies have shown that inflammatory mediators such as TNF-alpha induce insulin resistance, possibly via disruption of signal transduction pathways.

There is compelling evidence that inflammation and chronic infection play an essential role in the development of type 2 diabetes, and studies in humans suggest that circulating inflammatory marker levels may predict type 2 diabetes years in advance of the onset of these diseases.

AGEs activate receptors for AGEs (RAGEs). These receptors are found on surfaces of smooth muscles, endothelial cells, neurons, and monocytes/macrophages and in the periodontium. A 50% increase in messenger RNA for RAGEs was identified in the gingival tissues of subjects with type 2 diabetes. Hyperglycemia results in increased expression of RAGEs and AGE-RAGE interaction on the endothelium, increasing vascular permeability.

Glycation, which occurs when insulin doesn't metabolize sugars properly, destroys the collagen in blood vessels (collagen is a structural protein found all over the body, not just in the skin) and ultimately causes it to become brittle and form plaque.Advanced glycation end products (AGEs) are proteins or lipids that become glycated as a result of exposure to sugars. They can be a factor in aging and in the development or worsening of many degenerative diseases, such as diabetes, atherosclerosis, chronic kidney disease, and Alzheimer's disease.

AGE-RAGE interaction on monocytes increases cellular oxidant stress and activates the transcription factor nuclear factor-κB, resulting in increased production of proinflammatory cytokines such as interleukin-1β and TNF-α.

Both TNF-alpha and IL-6 have been shown to impair intracellular insulin signaling, which may lead to insulin resistance.

Periodontal disease and diabetes are both associated with an increase in pro-inflammatory and a decrease in antiinflammatory cytokines cauding the body by increasing the amount of certain hormones such as cortisol and adrenaline. These hormones work against the action of insulin and, as a result, the body’s production of glucose increases, which results in high blood sugar levels. The high blood sugar level lead to progression of the infection with subsequent more pain and stress and the situation can go out of control.