TNF and Hyperglycemia: Chronic hyperglycemia is known to enhance the production and accumulation of AGEs in the periodontal tissues,12 which in turn induces a state of oxidative stress in the targeted tissues, thereby augmenting inflammation.12 In addition, according to Sonnenschein and Meyle,32 persistent hyperglycemia alters the function of leukocytes and produces reactive oxygen species than enhance the expression and concentrations of destructive inflammatory cytokines (such as TNF-α, IL-1-beta and IL-6) in body fluids, including UWS.