Mostafa El-Shafei¹, Iman Hassan Ibrahim², Mai shafeek³, Mai mohammed said^4,

Cytokines play a central role in the host ̓s response to the periodontal film. Although the pathways through which diabetes affects periodontal status are well understood, less is known about the impact of periodontal diseases on the diabetes-related inflammatory state. This review attempts to explain the immunobiological connection between periodontal diseases and type 2 diabetes mellitus. Subjects and methods: Patients were selected among patients presented to the outpatient clinic of Oral Medicine and Periodontology Department, Faculty of Oral and Dental Medicine, Al-Azhar University. Patients were divided into four groups (Periodontitis group without diabetes, Diabetic group with periodontitis, Diabetic group without periodontitis and control group). Serum and GCF ofIL-6 and TNF-α were detected by ELISA. C-peptide was assessed by immune-enzymometric assay and glycatedhemoglobin (HbA1c %) was assessed by quantitative colorimetric method. Results: Serum levels and GCF levels of TNF-α were significantly higher in diabetic patients with periodontitis group compared to control group and diabetic group and periodontitis group. Also, serum levels and GCF levels of IL-6 were significantly higher in diabetic patients with periodontitis compared to control group and diabetic group and periodontitis group. Highest percent of glycatedhaemoglobin (HbA1c) was found in diabetic patients with peridontitis then diabetic group.Conclusion: Diabetes and periodontitis are closely related. Results give evidence that periodontal destruction and diabetes mellitus have a synergistic effect in elevating the proinflammatory cytokines.

Gingival Crevicular Fluid (GCF), Tumor Necrosis Factor-α (TNF-α), Interleukin-6(IL-6), glycatedhaemoglobin (HbA1c)