{"references": ["1. Lowe GD. The relationship between infection, inflammation and cardiovascular disease: an overview. Ann Periodontol 2001;6:1-8.", "2. Schmidt MI, Duncan BB, Sharrett AR, Lindberg G, Savage PJ, Offenbacher S et al. Markers of inflammation and prediction of diabetes mellitus in adults: a cohort study. Lancet 1999;353:1649-52", "3. Nishimura F, Soga Y, Iwamoto Y, Kudo C, Murayama Y. Periodontal disease as a part of the insulin resistance syndrome in diabetic patients. J Int Acad Periodontol 2005;7:16-20.", "4. Tan WC, Tay FB, Lim LP. Diabetes as a Risk Factor for Periodontal Disease: Current Status and Future considerations. Ann Acad Med Singapore 2006;35:571-81.", "5. Nassar H, Kantarci A, Van Dyke TE. Diabetic Periodontitis: a model for activated innate immunity and impaired resolution of inflammation. Periodontol 2000. 2007;43:233-44.", "6. Frantzis TG, Reeve CM, Brown AL. The ultrastructure of capillary basement membrane in the attached gingiva of diabetic and nondiabetic patients with periodontal disease. J Periodontol1971;42:406-11.", "7. Hove KA, Stallard RE. Diabetes and the periodontal patient. J Periodontol 1970; 41:713-18.", "8. McMullen JA, Van Dyke TE, Horosewicz HU, Genco RJ. Neutrophil chemotaxis in individuals with advanced periodontal disease and a genetic predisposition to diabetes mellitus. J Periodontol 1981;52:167-73.", "9. Lindhe J, Karring T. The anatomy of the periodontium. Lindhe J, ed. Textbook of Clinical Periodontology, 2nd edition. Copenhagen, Munksgaard; 1989:19-66.", "10. Mealey BL, MoritzAJ. Hormonal influences: effects of diabetes mellitus and endogenous female sex steroid hormones on the periodontium. Periodontol 2000. 2003;32:59\u201381.", "11. Acharya AB, Satyanarayan A, Thakur SL. Status of association studies linking diabetes mellitus and periodontal disease in India. Int J Diabetes in Dev Ctries 2010; 30:69-74.", "12. Katz J, Goultschin J, Benoliel R, Brautbar C. Human leucocyte antigen (HLA) DR4 positive association with rapidly progressive periodontitis. J Periodontol1987;58:607-10.", "13. Maria Emanuel Ryan, OanaCarnu, Angela Kamer. The influence of diabetes on the periodontal tissues. J Am DentAssoc2003;134:34-40.", "14. Westfelt E, Rylander H, Blohme G, Jonasson P, Lindhe J. The effect of periodontal therapy in diabetics. Results after 5 years. J ClinPeriodontol1996;23:92-100.", "15. Loos BG, Craandiji J, Hoek FJ, Wertheim-van Dillen PME van der Velden U. C-reactive protein and other markers of systemic inflammation in relation to cardiovascular diseases are elevated in periodontitis. J Periodontol 2000;71:1528\u201334.", "16. George W. Taylor. Bidirectional interrelationships between diabetes and periodontal diseases: an epidemiologic perspective. Ann Periodontol 2001;6:99-112.", "17. Nishimura F, Kono T, Fujimoto C, Iwamoto Y, MurayamaY. Negative effects of chronic inflammatory periodontal disease on diabetes mellitus. J Int Natl Acad Periodontol 2000;2:49-55.", "18. Martorelli de Lima AF, Cury CC, Palioto DB, Duro AM, da Silva RC, Wolff LF. Therapy with adjunctive doxycycline local delivery in patients with type 1 diabetes mellitus and periodontitis. J Clin Periodontol 2004;31:648-53.", "19. Llambes F, Silvestre FJ, Hern\u00e1ndez-Mijares A, Guiha R, Caffesse R. Effect of non-surgical periodontal treatment with or without doxycycline on the periodontium of type 1 diabetic patients. J Clin Periodontol 2005;32:915-20.", "20. Lamster IB, Lalla E. Periodontal Disease and Diabetes M e l l i t u s : D i s c u s s i o n , C o n c l u s i o n a n d Recommendations.Ann Periodontol 2001;6:146-49."]}

Periodontitis is an inflammatory disease affecting the supporting structures of teeth(periodontal ligament and alveolar bone). Association between diabetes mellitus and periodontal disease is well established. Periodontitis has been reported as one of the microvascular complications of diabetes. Diabetes is a risk factor for periodontitis. Both diseases are thought to share a common pathogenesis. Poor control of diabetes with HBA1c > 8 has adverse effects on the periodontium as well as the response to periodontal therapy. Periodontitis has been shown to adversely effect glycaemic control and periodontal therapy has been postulated to improve glycaemic control in diabetics. n attempt to review the A is made herein bidirectional relationship between periodontitis and diabetes mellitus so that periodontal health is considered as an integral part of management of diabetes.