Zalim Kudaev, founder of the Teeth in One Day clinic network, has warned that diabetes and periodontitis feed into each other to form a dangerous cycle, speaking in an interview with Russian news outlet Lenta.ru.
The medical expert stated that diabetes and periodontitis are no longer viewed as isolated diagnoses. Doctors increasingly observe a vicious cycle in which both conditions continuously reinforce one another, deteriorating a patient's prognosis and overall quality of life.
Kudaev explained that the process begins when diabetes alters the internal environment of the oral cavity, leaving tissues vulnerable to infection. Patients suffering from diabetes experience a marked reduction in salivation rate alongside changes in saliva composition. This weakens the natural protective barriers of the mouth and creates an ideal breeding ground for caries-causing bacteria to thrive.
In addition, diabetic microangiopathy impairs blood microcirculation in oral tissues. As a result, periodontal tissues suffer from a lack of oxygen and vital nutrients, become less efficient at removing metabolic waste products, and heal much slower. Kudaev noted that this significantly elevates the risk of developing gingivitis, which can subsequently progress to periodontitis, a chronic inflammatory disease capable of causing tooth loss.
Periodontitis is an advanced form of gum disease characterized by chronic inflammation that damages the soft tissue and destroys the alveolar bone supporting the teeth. Diabetes is a long-term metabolic disorder where the body either cannot produce sufficient insulin or cannot effectively use the insulin it produces, leading to elevated blood glucose levels. Microangiopathy is a recognized complication of diabetes where small blood vessels become damaged and narrow, restricting normal blood flow throughout localized tissues.
Gum inflammation affects blood sugar
The relationship also operates in reverse, as periodontitis actively interferes with diabetes management. Kudaev highlighted that chronic inflammation in the gums causes a continuous release of pro-inflammatory cytokines into the body, specifically IL-1β, TNF-α, and IL-6.
Once these inflammatory substances enter the systemic bloodstream, they contribute to the development of insulin resistance. Under these conditions, body cells respond poorly to insulin, making blood glucose levels substantially harder to regulate. Cytokines are signaling proteins produced by immune cells that mediate and regulate inflammation, but when persistently elevated, they disrupt normal cellular metabolism.
Kudaev added that bacteria from inflamed gums temporarily enter the bloodstream, maintaining a state of systemic inflammation across the body that further complicates diabetes compensation. This creates a self-sustaining cycle where diabetes weakens oral defenses, periodontitis intensifies systemic inflammation and worsens blood sugar control, and impaired glucose regulation further degrades immune function and gum health.
Increased risks and dentist advice
Statistical data highlights the extent of the risk, with Kudaev noting that individuals with diabetes face a two- to three-fold higher risk of developing periodontitis compared to people without the disease. He urged diabetic patients not to ignore their oral health and to seek prompt treatment for periodontitis to reduce the likelihood of severe systemic complications.
The warning follows separate guidance from dentist Rita Cruz de Souza, who previously cautioned that certain home remedies for bad breath pose serious risks to dental health. Cruz de Souza specifically singled out water mixed with lemon juice used as a homemade mouthwash as one of the most dangerous practices for tooth enamel and oral health.
