The results of this study confirmed a previous study that found that TNF-α had a close relationship with periodontitis and type 2 DM.20TNF-α is produced as an inflammatory response in periodontitis and is an important additional factor in insulin sensitivity in type 2 DM.21, 22The high levels of inflammatory mediators, such as TNF-α, contribute to increased insulin resistance. Here, INS is linked to Insulin resistance.