One mechanistic explanation for this relationship is that sustained hyperglycemia upregulates the expression of toll-like receptors (TLRs) and enhances the production of pro-inflammatory cytokines, such as interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α), within periodontal tissues, thereby amplifying the local inflammatory response [5]. Here, TNF is linked to Hyperglycemia.