{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T01:34:38Z","timestamp":1791855278226,"version":"4.3.4"},"reference-count":56,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T00:00:00Z","timestamp":1745193600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Victor Babes University of Medicine and Pharmacy, Timi\u0219oara","award":["4814\/02.10.2023"],"award-info":[{"award-number":["4814\/02.10.2023"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: The bidirectional relationship between diabetes mellitus (DM) and periodontal disease (PD) has garnered increasing attention due to shared inflammatory mechanisms and mutual disease exacerbation. In Romania, despite a high prevalence of diabetes and PD, integration of oral health into diabetes care remains limited. This study aimed to investigate the association between glycemic control, salivary inflammatory biomarkers (IL-1\u03b2, IL-6, MMP-8), and periodontal status in diabetic patients. Additionally, it evaluated patients\u2019 awareness of oral health risks and their communication with healthcare providers regarding periodontal care. Methods: A cross-sectional, observational study was conducted between May and December 2024, involving 79 adult patients with confirmed type 1 or type 2 DM. Periodontal examinations assessed probing pocket depth (PPD), clinical attachment level (CAL), plaque index (PI), and bleeding on probing (BOP). Salivary samples were collected to quantify IL-1\u03b2, IL-6, and MMP-8. Participants also completed a structured questionnaire on oral symptoms, hygiene practices, and awareness of the diabetes\u2013periodontitis link. Correlation and t-test analyses were used to explore associations between clinical, biochemical, and self-reported variables. Results: Most participants had advanced periodontitis (65.8% Stage IV; 72.2% Grade C). IL-1\u03b2 and IL-6 were positively correlated (r = 0.34, p &lt; 0.01), while MMP-8 correlated with PI (r = 0.28) and BOP (r = 0.26). Inflammatory markers showed weak correlation with HbA1c. Notably, patients with higher oral health knowledge reported worse clinical indices, suggesting increased symptom awareness rather than preventive effectiveness. Conclusions: This study reinforces the inflammatory link between DM and PD and highlights the need for integrated care models. Periodontal screening and education should be embedded within diabetes management, particularly in high-risk populations.<\/jats:p>","DOI":"10.3390\/jcm14082847","type":"journal-article","created":{"date-parts":[[2025,4,21]],"date-time":"2025-04-21T04:08:26Z","timestamp":1745208506000},"page":"2847","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Glycemic Control, Inflammatory Mediators, and Periodontal Health: A Cross-Sectional Study in Patients with Diabetes"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-1686-0150","authenticated-orcid":false,"given":"Vanessa","family":"Bolchis","sequence":"first","affiliation":[{"name":"Translational and Experimental Clinical Research Centre in Oral Health, Department of Preventive, Community Dentistry and Oral Health, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300040 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2705-5020","authenticated-orcid":false,"given":"Daniela","family":"Jumanca","sequence":"additional","affiliation":[{"name":"Translational and Experimental Clinical Research Centre in Oral Health, Department of Preventive, Community Dentistry and Oral Health, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300040 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6548-9607","authenticated-orcid":false,"given":"Ramona","family":"Dumitrescu","sequence":"additional","affiliation":[{"name":"Translational and Experimental Clinical Research Centre in Oral Health, Department of Preventive, Community Dentistry and Oral Health, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300040 Timisoara, Romania"},{"name":"Clinic of Preventive, Community Dentistry and Oral Health, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9946-2517","authenticated-orcid":false,"given":"Octavia","family":"Balean","sequence":"additional","affiliation":[{"name":"Translational and Experimental Clinical Research Centre in Oral Health, Department of Preventive, Community Dentistry and Oral Health, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300040 Timisoara, Romania"},{"name":"Clinic of Preventive, Community Dentistry and Oral Health, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicoleta A.","family":"Toderas","sequence":"additional","affiliation":[{"name":"Specialization in Clinical Psychology and Psychotherapy, Department of Psychology, Faculty of Sociology and Psychology, West University of Timi\u0219oara, 300223 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Popescu","sequence":"additional","affiliation":[{"name":"Second Department of Internal Medicine, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300041 Timisoara, Romania"},{"name":"Department of Diabetes, \u201cPius Brinzeu\u201d Emergency Hospital, 300723 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3875-8143","authenticated-orcid":false,"given":"Anca","family":"Marcu","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Pharmacology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, PtaEfimie Murgu Nr. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7749-1384","authenticated-orcid":false,"given":"Catalin","family":"Marian","sequence":"additional","affiliation":[{"name":"Department of Biochemistry and Pharmacology, \u201cVictor Babes\u201d University of Medicine and Pharmacy, PtaEfimie Murgu Nr. 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atena","family":"Galuscan","sequence":"additional","affiliation":[{"name":"Translational and Experimental Clinical Research Centre in Oral Health, Department of Preventive, Community Dentistry and Oral Health, \u201cVictor Babes\u201d University of Medicine and Pharmacy, 300040 Timisoara, Romania"},{"name":"Clinic of Preventive, Community Dentistry and Oral Health, \u201cVictor Babes\u201d University of Medicine and Pharmacy, Eftimie Murgu Sq. No 2, 300041 Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,4,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1","DOI":"10.4103\/2277-9531.127541","article-title":"The Prevention and Control the Type-2 Diabetes by Changing Lifestyle and Dietary Pattern","volume":"3","author":"Asif","year":"2014","journal-title":"J. Educ. Health Promot."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Velikova, T.V., Kabakchieva, P.P., Assyov, Y.S., and Georgiev, T.A. (2021). Targeting Inflammatory Cytokines to Improve Type 2 Diabetes Control. BioMed Res. Int., 2021.","DOI":"10.1155\/2021\/7297419"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Bolchis, V., Alexa, I., Toderas, N.A., Dumitrescu, R., Sava-Rosianu, R., Balean, O., Alexa, V.T., Popescu, S., Jumanca, D., and Galuscan, A. (2025). Associations Between Lifestyle Factors, Oral Health Behaviors, and Glycemic Control in Type 2 Diabetic Patients. J. Clin. Med., 14.","DOI":"10.3390\/jcm14020450"},{"key":"ref_4","first-page":"72","article-title":"Prevalence of Periodontal Disease, Its Association with Systemic Diseases and Prevention","volume":"11","author":"Nazir","year":"2017","journal-title":"Int. J. Health Sci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1902\/jop.2009.090510","article-title":"Salivary Interleukin-6, Matrix Metalloproteinase-8, and Osteoprotegerin in Patients with Periodontitis and Diabetes","volume":"81","author":"Costa","year":"2010","journal-title":"J. Periodontol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"900","DOI":"10.1902\/jop.2016.150727","article-title":"Systemic Inflammatory Biomarkers and Their Association with Periodontal and Diabetes-Related Factors in the Diabetes and Periodontal Therapy Trial, A Randomized Controlled Trial","volume":"87","author":"Geisinger","year":"2016","journal-title":"J. Periodontol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"430","DOI":"10.4103\/jehp.jehp_1382_23","article-title":"The Effects of Synbiotic Supplementation along with Non-Surgical Periodontal Therapy in Improving the Metabolic Status and Inflammatory Markers in Type 2 Diabetes Mellitus Patients with Periodontal Disease: A Double-Blind Randomized Clinical Trial","volume":"13","author":"Yarahmadi","year":"2024","journal-title":"J. Educ. Health Promot."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Sridharan, G. (2023). The Two-Way Relationship between Diabetes Mellitus and Periodontal Disease: A New Insight. Dentistry, IntechOpen.","DOI":"10.5772\/intechopen.100796"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Dumitrescu, R., Bolchis, V., Popescu, S., Ivanescu, A., Bolos, A., Jumanca, D., and Galuscan, A. (2025). Oral Health and Quality of Life in Type 2 Diabetic Patients: Key Findings from a Romanian Study. J. Clin. Med., 14.","DOI":"10.3390\/jcm14020400"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Aleksej\u016bnien\u0117, J., P\u016brien\u0117, A., Rimkervicius, A., Amariei, C., Oancea, R., Porosencova, T., Porosencov, E., Nikolovska, J., Mirnaya, E., and Serova-Papakul, A. (2020). Knowledge, Dentist Confidence and Management of Periodontal Patients among General Dentists from Belarus, Lithuania, Macedonia, Moldova and Romania. BMC Oral Health, 20.","DOI":"10.1186\/s12903-020-1033-9"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"P\u0103unic\u0103, I., Giurgiu, M., Dumitriu, A.S., P\u0103unic\u0103, S., Pantea Stoian, A.M., Martu, M.-A., and Serafinceanu, C. (2023). The Bidirectional Relationship between Periodontal Disease and Diabetes Mellitus\u2014A Review. Diagnostics, 13.","DOI":"10.3390\/diagnostics13040681"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"667","DOI":"10.1016\/j.archoralbio.2014.11.008","article-title":"Interrelationship between Diabetes and Periodontitis: Role of Hyperlipidemia","volume":"60","author":"Zhou","year":"2015","journal-title":"Arch. Oral Biol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"577","DOI":"10.1038\/s41415-019-0794-5","article-title":"Periodontitis and Diabetes","volume":"227","author":"Preshaw","year":"2019","journal-title":"Br. Dent. J."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"2146160","DOI":"10.1155\/2020\/2146160","article-title":"Global Prevalence of Periodontal Disease and Lack of Its Surveillance","volume":"2020","author":"Nazir","year":"2020","journal-title":"Sci. World J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"B2","DOI":"10.1093\/eurheartj\/suq002","article-title":"European Workshop in Periodontal Health and Cardiovascular Disease","volume":"12","author":"Sanz","year":"2010","journal-title":"Eur. Heart J. Suppl."},{"key":"ref_16","first-page":"1270","article-title":"Awareness of Diabetic Patients Regarding the Bidirectional Association between Periodontal Disease and Diabetes Mellitus: A Public Oral Health Concern","volume":"21","author":"Siddiqi","year":"2020","journal-title":"J. Contemp. Dent. Pract."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1111\/joor.12339","article-title":"Periodontal Treatment and H b A 1c Levels in Subjects with Diabetes Mellitus","volume":"43","author":"Altamash","year":"2016","journal-title":"J. Oral Rehabil."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Liccardo, D., Cannavo, A., Spagnuolo, G., Ferrara, N., Cittadini, A., Rengo, C., and Rengo, G. (2019). Periodontal Disease: A Risk Factor for Diabetes and Cardiovascular Disease. Int. J. Mol. Sci., 20.","DOI":"10.3390\/ijms20061414"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1111\/jcpe.12803","article-title":"An Update on the Evidence for Pathogenic Mechanisms That May Link Periodontitis and Diabetes","volume":"45","author":"Polak","year":"2018","journal-title":"J. Clin. Periodontol."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Ebersole, J.L., Kirakodu, S.S., Zhang, X.D., Dawson, D., and Miller, C.S. (2024). Salivary Features of Periodontitis and Gingivitis in Type 2 Diabetes Mellitus. Sci. Rep., 14.","DOI":"10.1038\/s41598-024-77434-2"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"216","DOI":"10.1111\/jcpe.13393","article-title":"Salivary Biomarkers for Discriminating Periodontitis in the Presence of Diabetes","volume":"48","author":"Miller","year":"2021","journal-title":"J. Clin. Periodontol."},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Pecci-Lloret, M.P., Linares-P\u00e9rez, C., Pecci-Lloret, M.R., Rodr\u00edguez-Lozano, F.J., and O\u00f1ate-S\u00e1nchez, R.E. (2024). Oral Manifestations in Pregnant Women: A Systematic Review. J. Clin. Med., 13.","DOI":"10.3390\/jcm13030707"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Poudel, P., Griffiths, R., Wong, V.W., Arora, A., Flack, J.R., Khoo, C.L., and George, A. (2018). Oral Health Knowledge, Attitudes and Care Practices of People with Diabetes: A Systematic Review. BMC Public Health, 18.","DOI":"10.1186\/s12889-018-5485-7"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1111\/j.1600-0757.2008.00288.x","article-title":"Saliva as a Diagnostic Tool for Periodontal Disease: Current State and Future Directions","volume":"50","author":"Giannobile","year":"2009","journal-title":"Periodontol. 2000"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"407","DOI":"10.1111\/jcpe.12392","article-title":"Standards for Reporting Chronic Periodontitis Prevalence and Severity in Epidemiologic Studies: Proposed Standards from the Joint EU\/USA Periodontal Epidemiology Working Group","volume":"42","author":"Holtfreter","year":"2015","journal-title":"J. Clin. Periodontol."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"485","DOI":"10.4239\/wjd.v10.i9.485","article-title":"Oral Manifestations in Patients with Diabetes Mellitus","volume":"10","author":"Rohani","year":"2019","journal-title":"World J. Diabetes"},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Zhang, R., Wu, J., Zhu, J., Wang, X., and Song, J. (2022). Bibliometric Analysis of Research Trends and Characteristics of Drug-Induced Gingival Overgrowth. Front. Public Health, 10.","DOI":"10.3389\/fpubh.2022.979861"},{"key":"ref_28","first-page":"1","article-title":"Clinical Periodontal Diagnosis","volume":"92","author":"Salvi","year":"2023","journal-title":"Periodontol. 2000"},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Badea (Paun), A.G., Bocanet, V.I., Badea, I.C., Chifor, R., Duma, L.T., and Borzan, C.M. (2023). Relationship between Behavior and Periodontal Health Self-Perception in Diabetic and Non-Diabetic Patients from Transylvania, Romania\u2014A Self-Report Study, Including the Desire to Use a Mobile App for Oral Care Improvements. Medicina, 59.","DOI":"10.3390\/medicina59081419"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1237","DOI":"10.1007\/s00784-011-0621-0","article-title":"Periodontal Inflamed Surface Area and C-Reactive Protein as Predictors of HbA1c: A Study in Indonesia","volume":"16","author":"Susanto","year":"2012","journal-title":"Clin. Oral Investig."},{"key":"ref_31","doi-asserted-by":"crossref","unstructured":"Kim, E.-K., Lee, S.G., Choi, Y.-H., Won, K.-C., Moon, J.S., Merchant, A.T., and Lee, H.-K. (2013). Association between Diabetes-Related Factors and Clinical Periodontal Parameters in Type-2 Diabetes Mellitus. BMC Oral Health, 13.","DOI":"10.1186\/1472-6831-13-64"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"Mohamed, H.G., Idris, S.B., Ahmed, M.F., B\u00f8e, O.E., Mustafa, K., Ibrahim, S.O., and \u00c5str\u00f8m, A.N. (2013). Association between Oral Health Status and Type 2 Diabetes Mellitus among Sudanese Adults: A Matched Case-Control Study. PLoS ONE, 8.","DOI":"10.1371\/journal.pone.0082158"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"e3226","DOI":"10.1097\/MD.0000000000003226","article-title":"The Prevalence and Associated Factors of Periodontitis According to Fasting Plasma Glucose in the Korean Adults: The 2012\u20132013 Korea National Health and Nutrition Examination Survey","volume":"95","author":"Hong","year":"2016","journal-title":"Medicine"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"622","DOI":"10.1111\/jcpe.12420","article-title":"Prevalence of Periodontitis in an Adult Population from an Urban Area in North Italy: Findings from a Cross-sectional Population-based Epidemiological Survey","volume":"42","author":"Aimetti","year":"2015","journal-title":"J. Clin. Periodontol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.1007\/s00784-017-2192-1","article-title":"Biomarker Levels in Gingival Crevicular Fluid of Generalized Aggressive Periodontitis Patients after Non-Surgical Periodontal Treatment","volume":"22","author":"Romano","year":"2018","journal-title":"Clin. Oral Investig."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Romano, F., Del Buono, W., Bianco, L., Arena, M., Mariani, G.M., Di Scipio, F., Berta, G.N., and Aimetti, M. (2020). Gingival Crevicular Fluid Cytokines in Moderate and Deep Sites of Stage III Periodontitis Patients in Different Rates of Clinical Progression. Biomedicines, 8.","DOI":"10.3390\/biomedicines8110515"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Cecoro, G., Annunziata, M., Iuorio, M.T., Nastri, L., and Guida, L. (2020). Periodontitis, Low-Grade Inflammation and Systemic Health: A Scoping Review. Medicina, 56.","DOI":"10.3390\/medicina56060272"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"S113","DOI":"10.1111\/jcpe.12059","article-title":"A Review of the Evidence for Pathogenic Mechanisms That May Link Periodontitis and Diabetes","volume":"40","author":"Taylor","year":"2013","journal-title":"J. Clin. Periodontol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1038\/sj.bdj.2014.907","article-title":"Diabetes and Periodontal Disease: A Two-Way Relationship","volume":"217","author":"Casanova","year":"2014","journal-title":"Br. Dent. J."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"710","DOI":"10.1034\/j.1600-051x.2001.028007710.x","article-title":"Elevated Blood Glucose Levels in Patients with Severe Periodontal Disease","volume":"28","author":"Katz","year":"2001","journal-title":"J. Clin. Periodontol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"S159","DOI":"10.1111\/jcpe.12945","article-title":"Staging and Grading of Periodontitis: Framework and Proposal of a New Classification and Case Definition","volume":"45","author":"Tonetti","year":"2018","journal-title":"J. Clin. Periodontol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"2135","DOI":"10.1007\/s00784-018-2469-z","article-title":"Gingival Crevicular Fluid Levels of Human Beta-Defensin-1 in Type 2 Diabetes Mellitus and Periodontitis","volume":"22","author":"Yilmaz","year":"2018","journal-title":"Clin. Oral Investig."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1007\/s00125-011-2342-y","article-title":"Periodontitis and Diabetes: A Two-Way Relationship","volume":"55","author":"Preshaw","year":"2012","journal-title":"Diabetologia"},{"key":"ref_44","doi-asserted-by":"crossref","unstructured":"Rapone, B., Ferrara, E., Corsalini, M., Qorri, E., Converti, I., Lorusso, F., Delvecchio, M., Gnoni, A., Scacco, S., and Scarano, A. (2021). Inflammatory Status and Glycemic Control Level of Patients with Type 2 Diabetes and Periodontitis: A Randomized Clinical Trial. Int. J. Environ. Res. Public Health, 18.","DOI":"10.3390\/ijerph18063018"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"S173","DOI":"10.1111\/jcpe.12946","article-title":"Periodontitis: Consensus Report of Workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri-Implant Diseases and Conditions","volume":"45","author":"Papapanou","year":"2018","journal-title":"J. Clin. Periodontol."},{"key":"ref_46","doi-asserted-by":"crossref","unstructured":"Rapone, B., Ferrara, E., Corsalini, M., Converti, I., Grassi, F.R., Santacroce, L., Topi, S., Gnoni, A., Scacco, S., and Scarano, A. (2020). 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, 17.","DOI":"10.3390\/ijerph17155467"},{"key":"ref_47","first-page":"81","article-title":"The Role of Polyunsaturated Fatty Acids (n-3 PUFAs) on the Pancreatic \u03b2-Cells and Insulin Action","volume":"7","author":"Baynes","year":"2018","journal-title":"Adipocyte"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"329","DOI":"10.2337\/diacare.16.1.329","article-title":"Periodontal Disease. The Sixth Complication of Diabetes Mellitus","volume":"16","year":"1993","journal-title":"Diabetes Care"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"1211","DOI":"10.1016\/S0140-6736(17)32154-2","article-title":"Global, Regional, and National Incidence, Prevalence, and Years Lived with Disability for 328 Diseases and Injuries for 195 Countries, 1990\u20132016: A Systematic Analysis for the Global Burden of Disease Study 2016","volume":"390","author":"Vos","year":"2017","journal-title":"Lancet"},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1111\/prd.12002","article-title":"Inflammatory and Immune Pathways in the Pathogenesis of Periodontal Disease","volume":"64","author":"Cekici","year":"2014","journal-title":"Periodontol. 2000"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"18","DOI":"10.29245\/2689-9981\/2020\/1.1155","article-title":"The Fascination of Cytokine Immunological Science","volume":"3","author":"Lissoni","year":"2020","journal-title":"J. Infect."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"111615","DOI":"10.1016\/j.diabres.2024.111615","article-title":"The Association between Interleukin Family and Diabetes Mellitus and Its Complications: An Overview of Systematic Reviews and Meta-Analyses","volume":"210","author":"Jin","year":"2024","journal-title":"Diabetes Res. Clin. Pract."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1111\/prd.12298","article-title":"Diabetes as a Risk Factor for Periodontal Disease\u2014Plausible Mechanisms","volume":"83","author":"Polak","year":"2020","journal-title":"Periodontol. 2000"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"1212","DOI":"10.1902\/jop.2015.150285","article-title":"Periodontal Inflammatory Burden and Salivary Matrix Metalloproteinase-8 Concentration Among Patients with Chronic Kidney Disease at the Predialysis Stage","volume":"86","author":"Nylund","year":"2015","journal-title":"J. Periodontol."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"1409","DOI":"10.1902\/jop.2008.070623","article-title":"Subantimicrobial-Dose Doxycycline Modulates Gingival Crevicular Fluid Biomarkers of Periodontitis in Postmenopausal Osteopenic Women","volume":"79","author":"Golub","year":"2008","journal-title":"J. Periodontol."},{"key":"ref_56","doi-asserted-by":"crossref","unstructured":"Guerrero-Giron\u00e9s, J., Ros-Valverde, A., Pecci-Lloret, M.P., Rodr\u00edguez-Lozano, F.J., and Pecci-Lloret, M.R. (2021). Association between Pulpal-Periapical Pathology and Autoimmune Diseases: A Systematic Review. J. Clin. Med., 10.","DOI":"10.3390\/jcm10214886"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/8\/2847\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:18:32Z","timestamp":1760030312000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/8\/2847"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,21]]},"references-count":56,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,4]]}},"alternative-id":["jcm14082847"],"URL":"https:\/\/doi.org\/10.3390\/jcm14082847","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,21]]}}}