Letter to the Editor
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Diabetes. Jul 15, 2024; 15(7): 1651-1653
Published online Jul 15, 2024. doi: 10.4239/wjd.v15.i7.1651
Bidirectional link between periodontitis and systemic inflammation in diabetic retinopathy
Prateek Nishant, Sony Sinha, Ranjeet Kumar Sinha, Arvind Kumar Morya
Prateek Nishant, Department of Ophthalmology, ESIC Medical College, Patna 801103, Bihar, India
Sony Sinha, Department of Ophthalmology-Vitreo-Retina, Neuro-Ophthalmology and Oculoplasty, All India Institute of Medical Sciences, Patna 801507, Bihar, India
Ranjeet Kumar Sinha, Department of Community Medicine, Patna Medical College, Patna 800004, Bihar, India
Arvind Kumar Morya, Department of Ophthalmology, All India Institute of Medical Sciences, Hyderabad 508126, Telangana, India
Author contributions: Morya AK designed the research; Nishant P and Sinha S performed the research; Nishant P and Sinha RK analyzed the data and wrote the letter; and Sinha S revised the letter.
Conflict-of-interest statement: There are no conflicts of interest.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Arvind Kumar Morya, Additional Professor, Head of the Department, Department of Ophthalmology, All India Institute of Medical Sciences, Bibi Nagar, Hyderabad 508126, Telangana, India. bulbul.morya@gmail.com
Received: March 25, 2024
Revised: May 3, 2024
Accepted: May 20, 2024
Published online: July 15, 2024
Processing time: 105 Days and 0.3 Hours
Abstract

Periodontitis is independently associated with numerous lifestyle diseases. Diabetic patients have approximately threefold increased odds of periodontitis, which in turn increases the risk of systemic inflammation. The study by Thazhe Poyil et al is an effort to establish the inflammatory link between diabetic re-tinopathy (DR) and periodontitis based on the periodontal inflamed surface area in diabetic patients with and without DR. To further advance the study, we suggest refining the eligibility criteria to explicitly state the clinical correlates of periodontitis and DR, larger sample size and improved sampling methodology, matching of baseline characteristics of the two groups, as well as improved statistical approach and interpretation of the study findings. Measurement of hemoglobin A1c (HbA1c) in studies comparing type 2 diabetes mellitus patients with DR of matched severity with and without periodontitis could provide a clearer picture of whether HbA1c level is indeed influenced by periodontitis.

Keywords: Glucose intolerance; Hyperglycemia; Inflammation; Research methodology; Vision

Core Tip: The study by Thazhe Poyil et al is an effort to establish the inflammatory link between diabetic retinopathy (DR) and periodontitis based on the periodontal inflamed surface area in diabetic patients with and without DR. To further advance the study, we suggest refining the eligibility criteria to explicitly state the clinical correlates of periodontitis and DR, larger sample size and improved sampling methodology, matching of baseline characteristics of the two groups, as well as an improved statistical approach and interpretation of the study findings.