REVIEW article
Front. Nutr.
Sec. Nutrition and Metabolism
Volume 12 - 2025 | doi: 10.3389/fnut.2025.1606223
The role of HbA1c in the bidirectional relationship between periodontitis and diabetes and related interventions: a narrative review
Provisionally accepted
- Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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The intricate relationship between periodontitis and diabetes mellitus (DM) has emerged as a focal point in contemporary medical research. This study aimed to explore the role of glycated hemoglobin (HbA1c) in this relationship, and also the mechanistic theories that may underlie this connection and summarized effective interventions.Methods: Articles were retrieved from PubMed/Medline, Web of Science. All studies focusing on this two-way relationship were included and evaluated.Results: A number of mechanism theories have been proposed, which include alterations in oral flora, suppressed anti-inflammatory and antidiabetic control mechanisms in periodontitis, gene silencing due to reduced DNA demethylation and significantly lower quantitative levels of Platelet-rich Fibrin (PRF). Non-surgical periodontal therapy (NSPT) is an effective intervention, and based on this, systemic antibiotics and propolis can be used. aPDT is also an adjunct to periodontal therapy, and indocyanine green is the product that is currently receiving more attention.Discussion: HbA1c links periodontitis and DM bidirectionally, with elevated levels worsening periodontal disease and tooth loss. Studies confirm this in diabetics and nondiabetics, though some findings conflict. While HbA1c may predict diabetes risk and periodontal severity, further research is needed to clarify this relationship.There is a bidirectional relationship between periodontitis and DM and HbA1c plays an important role in this relationship. This study has certain limitations regarding selection bias and methodology, necessitating further mechanistic exploration and clinical validation in subsequent research.
Keywords: Diabetes Mellitus, Periodontitis, Glycated hemoglobin, non-surgical periodontal therapy, Photodynamic therapy
Received: 04 Apr 2025; Accepted: 30 May 2025.
Copyright: © 2025 Du, Xiao, Luo, Li and Ren. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Yixing Ren, Affiliated Hospital of North Sichuan Medical College, Nanchong, China
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