increased susceptibility to oral infections, including periodontitis [18, 19]. There have

been several studies which have reported a significantly poorer periodontal health in

Type 2 DM patients and some of these reports have provided epidemiologic parameter

estimates of association and risk. The odds that have been reported for Type 2 diabetics

to have greater risk of destructive periodontal disease are from 2.6 to 4.0 [20, 21, and 22].

There have also been two population-based surveys that have provided epidemiologic

estimates of association for diabetes and attachment loss severity, with diabetic

individuals being twice as likely to have more severe attachment loss as those without

diabetes [23, 24].

 Current evidence supports the fact that inferior glycemic control contributes to

poorer periodontal health. Recent studies that have been published on the association

between glycemic control and periodontal disease have shown that inadequate glycemic

control is a significant factor associated with poorer periodontal health [25, 26, and 27].

The control of diabetes is directed at controlling the blood glucose levels within "normal

limits", and there is clear evidence that complications can be prevented by meticulous

control of hyperglycemia [28, 29]. Monitoring the effectiveness of glycemic control is

done by measuring the levels of glycated serum proteins, in particular glycated ca-

hemoglobin (HbAlc), which because of its incorporation into the red blood cells gives an

indication of the serum glucose levels over the preceding 2 to 3 months [30].

 Study Rationale

 Insulin-like growth factors (IGFs) belong to a family of polypeptide hormones, also

called somatomedins ("mediator of growth") [31]. IGF-1 is a well-characterized basic

peptide that has some unique characteristics and properties. It has growth-regulating,