Association of periodontal disease and diabetic retinopathy

Keywords: Periodontal disease, diabetes, diabetic retinopathy, periodontitis


The main problem of type II diabetes is that excessive levels of glucose in the blood damage the vascular endothelium causing complications, such as periodontal disease (PD) that, in people with diabetes, can compromise the patient's ability to maintain normal function. adequate metabolic control. Therefore, it is important to analyse the effect of PD status on complications in patients with type II diabetes; Previous studies have reported that there is a bidirectional relationship between PD and diabetic complications, but it has not been clarified whether PD affects the presence of complications such as diabetic retinopathy (DR). DR is a microvascular complication and is considered the main cause of visual loss worldwide, similarly, periodontitis is a microvascular chronic inflammatory condition that compromises the dental support tissues. This article was prepared as an update for health professionals and also to analyse PE and how it is related to the presence of DR. Based on the literature, we can conclude that the number of teeth is an independent risk factor for DR, greater bleeding on probing could affect the presence of DR, and that patients with DR seem to show greater susceptibility to PD. The bibliography also mentions that more studies should be carried out with large samples, adequate models that adjust confounding variables such as obesity, hypertension, other chronic-degenerative diseases, use of substances such as alcohol or cigarettes, also carrying out prospective analyses of the conditions of periodontitis and DR.


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Yamamoto Y, Morozumi T, Hirata T, Takahashi T, Fuchida S, Toyoda M, et al. Effect of Periodontal Disease on Diabetic Retinopathy in Type 2 Diabetic Patients: A Cross-sectional Pilot Study. J. Clin. Med. 2020;9(10):3234.

Bello-Chavolla OY, Rojas-Martinez R, Aguilar-Salinas CA, Hernández-Avila M. Epidemiology of diabetes mellitus in Mexico. Nutr. Rev. 2017; 75(suppl. 1):4-12.

Wu HQ, Wei X, Yao JY, Qi JY, Xie HM, Sang AM, et al. Association between retinopathy, nephropathy, and periodontitis in type 2 diabetic patients: a Meta-analysis. Int. J. Ophthalmol. 2021;14(1):141-7.

Amiri AA, Maboudi A, Bahar A, Farokhfar A, Daneshvar F, Khoshgoeian HR, et al. Relationship between type 2 diabetic retinopathy and periodontal disease in Iranian adults. N. Am. J. Med. Sci. 2014;6(4):190.

Alvarenga MOP, Miranda GHN, Ferreira RO, Saito MT, Fagundes NCF, Maia LC, et al. Association Between Diabetic Retinopathy and Periodontitis-A Systematic Review. Front. Public Health. 2021;8:550-614.

American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2012;35.

International Diabetes Federation. IDF Diabetes Atlas, 9th edn. Brussels, Belgium. Atlas de la Diabetes de la FID. 2019;9:1-169.

Lechner J, O'Leary OE, Stitt AW. The pathology associated with diabetic retinopathy. Vision Res. 2017;139:7-14.

Kang Q, Yang C. Oxidative stress and diabetic retinopathy: Molecular mechanisms, pathogenetic role and therapeutic implications. Redox Biol. 2020;37:101799.

Whitehead M, Wickremasinghe S, Osborne A, Van Wijngaarden P, Martin KR. Diabetic retinopathy: a complex pathophysiology requiring novel therapeutic strategies. Expert Opin. Biol. Ther. 2018;18(12):1257-1270.

Song SJ, Han K, Lee SS, Park JB. Association between the number of natural teeth and diabetic retinopathy among type 2 diabetes mellitus: The Korea national health and nutrition examination survey. Medicine (Baltimore). 2017;96(47):e8694.

HR V, Natesh S, Patil SR. Association between Diabetic Retinopathy and Chronic Periodontitis-A Cross-Sectional Study. Med. Sci. (Basel). 2018;6(4):104.

Lindner M, Arefnia B, Ivastinovic D, Sourij H, Lindner E, Wimmer G. Association of periodontitis and diabetic macular edema in various stages of diabetic retinopathy. Clin. Oral Investig. 2022;26(1):505-512.

Zhang X, Saaddine JB, Chou CF, Cotch MF, Cheng YJ, Geiss LS, et al. Prevalence of diabetic retinopathy in the United States, 2005-2008. JAMA. 2010;304(6):649-56.

Romero-Aroca P, Baget-Bernaldiz M, Pareja-Rios A, Lopez-Galvez M, Navarro-Gil R, Verges R. Diabetic Macular Edema Pathophysiology: Vasogenic versus Inflammatory. J. Diabetes Res. 2016;2016:2156273.

Bunce C, Wormald R. Leading causes of certification for blindness and partial sight in England & Wales. BMC. Public Health. 2006;6:58.

Pidro A, Ahmedbegovic-Pjano M, Grisevic S, Sofic-Drino V, Gabric K, Biscevic A. Epidemiology of Diabetic Retinopathy at Eye Clinic Svjetlost Sarajevo: Two Years Retrospective Single Center Study. Mater. Sociomed. 2019;31(4):290-293.

Flaxman SR, Bourne RRA, Resnikoff S, Ackland P, Braithwaite T, Cicinelli MV, et al. Global causes of blindness and distance vision impairment 1990-2020: a systematic review and meta-analysis. Lancet Glob. Health. 2017;5(12):e1221-e1234.

Wang W, Lo ACY. Diabetic Retinopathy: Pathophysiology and Treatments. Int. J. Mol. Sci. 2018;19(6):1816.

Paneni F, Beckman JA, Creager MA, Cosentino F. Diabetes and vascular disease: pathophysiology, clinical consequences, and medical therapy: part I. Eur. Heart J. 2013;34(31):2436-43.

Pitocco D, Spanu T, Di Leo M, Vitiello R, Rizzi U, Tartaglione L, et al. Diabetic foot infections: a comprehensive overview. Eur. Rev. Med. Pharmacol. Sci. 2019;23(suppl. 2):26-37.

Verhulst MJL, Loos BG, Gerdes VEA, Teeuw WJ. Evaluating All Potential Oral Complications of Diabetes Mellitus. Front. Endocrinol. (Lausanne). 2019;10:56.

Sohn EH, van Dijk HW, Jiao C, Kok PH, Jeong W, Demirkaya N, et al. Retinal neurodegeneration may precede microvascular changes characteristic of diabetic retinopathy in diabetes mellitus. Proc. Natl. Acad. Sci. U. S. A. 2016;113(19):e2655-64.

Simó-Servat O, Hernández C, Simó R. Diabetic Retinopathy in the Context of Patients with Diabetes. Ophthalmic Res. 2019;62(4):211-217.

Yin L, Zhang D, Ren Q, Su X, Sun Z. Prevalence and risk factors of diabetic retinopathy in diabetic patients: A community based cross-sectional study. Medicine (Baltimore). 2020;99(9):e19236.

Vujosevic S, Aldington SJ, Silva P, Hernández C, Scanlon P, Peto T, et al. Screening for diabetic retinopathy: new perspectives and challenges. Lancet Diabetes Endocrinol. 2020;8(4):337-347.

Rodríguez ML, Pérez S, Mena-Mollá S, Desco MC, Ortega ÁL. Oxidative Stress and Microvascular Alterations in Diabetic Retinopathy: Future Therapies. Oxid. Med. Cell. Longev. 2019;2019:4940825.

Pardo-Romero FF, Hernández LJ. EP: enfoques epidemiológicos para su análisis como problema de salud pública. Rev. Salud Publica (Bogota). 2018;20(2):258–264.

Liccardo D, Cannavo A, Spagnuolo G, Ferrara N, Cittadini A, Rengo C, et al. Periodontal Disease: A Risk Factor for Diabetes and Cardiovascular Disease. Int. J. Mol. Sci. 2019;20(6):1414.

Tandon A, Kamath YS, Gopalkrishna P, Saokar A, Prakash S, Sarpangala SB, et al. The association between diabetic retinopathy and periodontal disease. Saudi J. Ophthalmol. 2021;34(3):167-170.

Horikawa Y, Suzuki A, Enya M, Hashimoto KI, Nishida S, Kobayashi R, et al. Periodontal Disease May be Associated with the Occurrence of Diabetic Retinopathy: A Subgroup Analysis of The Survey of the Diabetes Coordination Notebook in Gifu. Exp. Clin. Endocrinol. Diabetes. 2020;128(4):231-238.

Fischer RG, Lira Junior R, Retamal-Valdes B, De-Figuereido LC, Malheiros Z, Stewart B, et al. Periodontal disease and its impact on general health in Latin America. Section V: Treatment of periodontitis. Braz. Oral Res. 2020;34(supp1. 1):e026.

Baeza M, Morales A, Cisterna C, Cavalla F, Jara G, Isamitt Y, et al. Effect of periodontal treatment in patients with periodontitis and diabetes: systematic review and meta-analysis. J. Appl. Oral Sci. 2020;28:e20190248.

Stöhr J, Barbaresko J, Neuenschwander M, Schlesinger S. Bidirectional association between periodontal disease and diabetes mellitus: a systematic review and meta-analysis of cohort studies. Sci. Rep. 2021;11(1):13686.

Noma H, Sakamoto I, Mochizuki H, Tsukamoto H, Minamoto A, Funatsu H, et al. Relationship between periodontal disease and diabetic retinopathy. Diabetes Care. 2004;27(2):615.

How to Cite
García-Hernández, E. L. (2022). Association of periodontal disease and diabetic retinopathy . Mexican Journal of Medical Research ICSA, 11(21), 19-24. Retrieved from