Abstract: Objective:To investigate the effect of artesunate (ART) combined with insulin (INS) on apoptosis of pancreatic cell in type 1 diabetic rats with periodontal disease and preliminarily explore its mechanism.Methods:A total of 50 male SD rats were randomly divided into 5 groups:normal control group(NC group), diabetes melli-tus with periodontal disease group(DM+PD group), ART intervention group with DM and PD (ART group), INS intervention group with DM and PD(INS group), and ART+INS intervention group with DM and PD(ART+INS group), with 10 rats in each group.Following successful modeling, the rats were administered the drug once a day and after four weeks, they were sacrificed under overdose anesthesia.Fasting blood glucose levels (FBG)were measured in all groups of rats.The serum levels of tumor necrosis factor-α (TNF-α)and interleukin-1β (IL-1β) were detected by enzyme-linked immunosorbent assay (ELISA).Alveolar bone resorption was detected by micro-computed tomography (Micro-CT).The histopathological changes of the pancreas and the expressions of Caspase-3, Bax and Bcl-2 proteins in islets were ob-served by hematoxylin-eosin (HE) staining and im-munohistochemistry (IHC).The mRNA and protein expression levels of Caspase-3, Bax and Bcl-2 in pancreatic tissue were detected by real-time fluorescence quanti-tative polymerase chain reaction (RT-qPCR) and western blotting.Results:Compared with NC group, the FBG of rats in DM+PD group significantly increased(P< 0.05); the serum levels of TNF-α and IL-1β significantly in-creased (P< 0.05); the alveolar bone resorption was significant (P< 0.05); the histopathological damage of pan-creatic islets was severe; the mRNA and protein expression levels of Caspase-3 and Bax in pancreatic tissue in-creased (P< 0.05), while the mRNA and protein expression levels of Bcl-2 decreased (P< 0.05).Compared with DM+PD group, the FBG of rats in ART group, INS group and ART+INS group decreased (P< 0.05); the serum levels of TNF-α and IL-1β significantly decreased (P< 0.05); the alveolar bone resorption decreased (P< 0.05); the histopathological damage of pancreatic islets were alleviated; the mRNA and protein expression levels of Cas-pase-3 and Bax in pancreatic tissue decreased (P< 0.05), while the mRNA and protein expression level of Bcl-2 increased (P< 0.05); the ART+INS group had a better effect than the ART and INS groups (P< 0.05).Conclusion:ART has a protective effect on pancreatic tissue in type 1 diabetic rats with periodontal disease, and the ef-fect of ART combined with INS is better.The mechanism may be related to the inhibition of inflammation and the regulation of Caspase-3/Bax/Bcl-2 apoptosis signaling pathway.