{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T21:42:54Z","timestamp":1780954974680,"version":"3.54.1"},"reference-count":34,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2018,11,23]],"date-time":"2018-11-23T00:00:00Z","timestamp":1542931200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Periodontal disease (PD), a chronic inflammatory condition characterized by destruction of the supporting tissues of the teeth, increases the risk of complications in diabetics. Diabetic retinopathy (DR) is a microvascular complication of prolonged hyperglycaemia. There appears to be a similarity in the pathogenesis of DR and PD. Hence, this study aimed to investigate the association, if any, between DR and PD, correlate the severity of DR with the severity of PD, and investigate the association between glycated haemoglobin (HbA1c), serum creatinine and periodontal variables. The periodontal status of 200 adult diabetic patients in the age group of 30\u201365 years with varying severity of DR was assessed. Evaluation of the severity of PD was assessed by recording clinical parameters. Haematological investigations including glycated haemoglobin (HbA1c) and serum creatinine were estimated before the initiation of treatment for DR. A statistically significant association between the mean duration of diabetes mellitus (DM) and the severity of DR and PD was found. The severity of PD was directly correlated with the severity of DR. There was a significant association between the levels of HbA1c and serum creatinine and severity of DR and PD. There could be a plausible relationship between DR and PD. Further prospective studies on a larger population with longer follow-ups are required to ascertain whether PD and its severity directly affect the progression and severity of DR.<\/jats:p>","DOI":"10.3390\/medsci6040104","type":"journal-article","created":{"date-parts":[[2018,11,23]],"date-time":"2018-11-23T12:20:28Z","timestamp":1542975628000},"page":"104","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Association between Diabetic Retinopathy and Chronic Periodontitis\u2014A Cross-Sectional Study"],"prefix":"10.3390","volume":"6","author":[{"given":"Veena","family":"H. R.","sequence":"first","affiliation":[{"name":"Department of Periodontology, K.L.E Society\u2019s Institute of Dental Sciences, Bangalore 560 022, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sribhargava","family":"Natesh","sequence":"additional","affiliation":[{"name":"Vitreoretina, Neuro-Ophthalmology and Ocular Oncology, Nethra Eye Hospital, Bangalore 560 094, India"},{"name":"Drishti Eye Hospitals, Raichur 562 110, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sudhir R.","family":"Patil","sequence":"additional","affiliation":[{"name":"Department of Periodontology, K.L.E Society\u2019s Institute of Dental Sciences, Bangalore 560 022, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2018,11,23]]},"reference":[{"key":"ref_1","first-page":"109","article-title":"Association of periodontal disease severity with diabetes duration and diabetic complications in patients with type 1 diabetes mellitus","volume":"8","author":"Moussa","year":"2006","journal-title":"J. Int. Acad. Periodontol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1414","DOI":"10.2337\/diacare.21.9.1414","article-title":"Global burden of diabetes, 1995\u20132025: Prevalence, numerical estimates, and projections","volume":"21","author":"King","year":"1998","journal-title":"Diabetes Care"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1016\/S2213-8587(17)30174-2","article-title":"Prevalence of diabetes and prediabetes in 15 States of India: Results from the ICMR-INDIAB population-based cross-sectional study","volume":"5","author":"Anjana","year":"2017","journal-title":"Lancet Diabetes Endocrinol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1177\/2040622314548679","article-title":"Early onset type 2 diabetes: Risk factors, clinical impact and management","volume":"5","author":"Wilmot","year":"2014","journal-title":"Ther. Adv. Chronic Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"143","DOI":"10.2337\/diacare.21.1.143","article-title":"Diabetic retinopathy","volume":"21","author":"Aiello","year":"1998","journal-title":"Diabetes Care"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"139","DOI":"10.4103\/1947-2714.128476","article-title":"Relationship between Type 2 Diabetic Retinopathy and Periodontal Disease in Iranian Adults","volume":"6","author":"Amiri","year":"2014","journal-title":"N. Am. J. Med. Sci."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"489","DOI":"10.4239\/wjd.v6.i3.489","article-title":"Diabetic retinopathy - ocular complications of diabetes mellitus","volume":"6","author":"Nentwich","year":"2015","journal-title":"World J. Diabetes"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1056\/NEJMra021678","article-title":"Diabetic retinopathy","volume":"350","author":"Frank","year":"2004","journal-title":"N. Engl. J. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1177\/0022034510381902","article-title":"Periodontal disease and incident diabetes: A seven-year study","volume":"90","author":"Ide","year":"2011","journal-title":"J. Dent. Res."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"713","DOI":"10.1902\/jop.1997.68.8.713","article-title":"Treatment of periodontal disease in diabetics reduces glycated hemoglobin","volume":"68","author":"Grossi","year":"1997","journal-title":"J. Periodontol."},{"key":"ref_11","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","author":"Loe","year":"1993","journal-title":"Diabetes Care"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1210\/jcem-69-2-317","article-title":"Severity, duration, and mechanisms of insulin resistance during acute infections","volume":"69","author":"Sammalkorpi","year":"1989","journal-title":"J. Clin. Endocrinol. Metab."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1034\/j.1600-051X.2002.290404.x","article-title":"Comparative evaluation of adjunctive oral irrigation in diabetics","volume":"29","author":"Ciancio","year":"2002","journal-title":"J. Clin. Periodontol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1016\/j.cyto.2011.02.010","article-title":"Gingival crevicular fluid and serum vascular endothelial growth factor: Their relationship in periodontal health, disease and after treatment","volume":"54","author":"Pradeep","year":"2011","journal-title":"Cytokine"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"764","DOI":"10.1007\/s001250050747","article-title":"The relationship between accumulation of advanced glycation end products and expression of vascular endothelial growth factor in human diabetic retinas","volume":"40","author":"Murata","year":"1997","journal-title":"Diabetologia"},{"key":"ref_16","first-page":"21","article-title":"Diabetic retinopathy: Clinical findings and management","volume":"16","author":"Viswanath","year":"2003","journal-title":"Commun. Eye Health"},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Wong, T.Y., Sun, J., Kawasaki, R., Ruamviboonsuk, P., Gupta, N., Lansingh, V.C., Maia, M., Matheng, W., Moreker, S., and Muqit, M.M.K. (2018). Guidelines on diabetic eye care. The international council of ophthalmology recommendations for screening, follow-up, referral, and treatment based on resource settings. Ophthalmology.","DOI":"10.1016\/j.ophtha.2018.04.007"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"610","DOI":"10.1902\/jop.1967.38.6.610","article-title":"The Gingival Index, the Plaque Index and the Retention Index System","volume":"38","author":"Loe","year":"1967","journal-title":"J. Periodontol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1387","DOI":"10.1902\/jop.2007.060264","article-title":"Case definitions for use in population-based surveillance of periodontitis","volume":"78","author":"Page","year":"2007","journal-title":"J. Periodontol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"615","DOI":"10.2337\/diacare.27.2.615","article-title":"Relationship between periodontal disease and diabetic retinopathy","volume":"27","author":"Noma","year":"2004","journal-title":"Diabetes Care"},{"key":"ref_21","first-page":"28","article-title":"Evaluation of the association between periodontal disease and diabetic retinopathy","volume":"62","author":"Banthia","year":"2014","journal-title":"Gen. Dent."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"532","DOI":"10.14219\/jada.archive.1990.0211","article-title":"Type II diabetes mellitus and periodontal disease","volume":"121","author":"Schossman","year":"1990","journal-title":"J. Am. Dent. Assoc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"777","DOI":"10.4103\/2230-8210.100673","article-title":"Oral manifestations in type-2 diabetes and related complications","volume":"16","author":"Bajaj","year":"2012","journal-title":"Indian J. Endocrinol. Metab."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"82","DOI":"10.1007\/s12020-016-1215-z","article-title":"Periodontitis is associated with diabetic retinopathy in non-obese adults","volume":"56","author":"Song","year":"2017","journal-title":"Endocrine"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"127","DOI":"10.1111\/j.1600-0757.2006.00193.x","article-title":"Diabetes mellitus and periodontal disease","volume":"44","author":"Mealey","year":"2007","journal-title":"Periodontol 2000"},{"key":"ref_26","first-page":"235","article-title":"Awareness and attitude of diabetic patients about their increased risk for oral diseases","volume":"9","author":"Eldarrat","year":"2011","journal-title":"Oral Health Prev. Dent."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1111\/j.1601-0825.2007.01430.x","article-title":"Interactions between chronic renal disease and periodontal disease","volume":"14","author":"Craig","year":"2008","journal-title":"Oral Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1056\/NEJMoa063186","article-title":"Treatment of periodontitis and endothelial function","volume":"9","author":"Tonetti","year":"2007","journal-title":"N. Eng. J. Med."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1902\/jop.2006.050165","article-title":"C-reactive protein level in patients with aggressive periodontitis","volume":"77","author":"Salzberg","year":"2006","journal-title":"J. Periodontol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1111\/j.1600-051X.2007.01173.x","article-title":"A systematic review and meta-analysis on C-reactive protein in relation to periodontitis","volume":"35","author":"Paraskeva","year":"2008","journal-title":"J. Clin. Periodontol."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/S0272-6386(03)00408-6","article-title":"Inflammatory parameters are independently associated with urinary albumin in type 2 diabetes mellitus","volume":"42","author":"Navarro","year":"2003","journal-title":"Am. J. Kidney Dis."},{"key":"ref_32","first-page":"19","article-title":"Effect of Oral Infections on Serum Creatinine Levels in Diabetic Rats","volume":"1","author":"Cintra","year":"2013","journal-title":"Int. J. Diabetol. Vasc. Dis. Res."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1136\/bjo.82.8.901","article-title":"Prevalence and risk factors for diabetic retinopathy among Omani diabetics","volume":"82","author":"Saad","year":"1998","journal-title":"Br. J. Ophthalmol."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Wong, C.W., Teo, B.W., Lamoureux, E., Ikram, M.K., Wang, J.J., Tai, S.E., Sethi, S., Wong, T.Y., and Sabanayagam, C. (2015). Serum Cystatin C, Markers of Chronic Kidney Disease, and Retinopathy in Persons with Diabetes. J. Diabetes Res.","DOI":"10.1155\/2015\/404280"}],"container-title":["Medical Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3271\/6\/4\/104\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T15:31:45Z","timestamp":1760196705000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3271\/6\/4\/104"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11,23]]},"references-count":34,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2018,12]]}},"alternative-id":["medsci6040104"],"URL":"https:\/\/doi.org\/10.3390\/medsci6040104","relation":{},"ISSN":["2076-3271"],"issn-type":[{"value":"2076-3271","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11,23]]}}}