On the other hand: Diabetes predisposes to periodontitis
Increased formation of glycosylated proteins (AGE = advanced glycation end products) occurs in diabetes patients in the presence of hyperglycemia. These proteins interact with endothelial cells, fibroblasts and other immune cells, thereby bringing about the release of cytokines and other inflammatory mediators. This gives further impetus to the bone resorption and soft tissue destruction that is already increased in periodontitis patients as well as to the heightened inflammatory response.
The poor perfusion of peripheral tissue that occurs frequently in diabetics, together with the elevated blood glucose values, further promote bacterial infections. As a consequence of this, the prevalence, progression and extent of periodontal destruction is much greater in patients with diabetes than in healthy individuals. This applies mainly to diabetics with poor blood glucose control, however. Patients with well controlled glucose metabolism are not at increased risk of periodontitis.