Can saliva offer an advantage in monitoring of diabetes mellitus? - A case control study

Abstract

Objectives: Diabetes Mellitus is emerging as a major health problem over these years. Present method of blood glucose monitoring by venepuncture is invasive leading to reduced patient compliance and thereby ineffective judicious monitoring. The need of the hour is to direct research in the direction of establishing painless and more acceptable blood glucose analysis method.The objective of the study is to conduct a comparative analysis of the concentrations of salivary glucose and blood glucose in type 2 diabetes mellitus patients. Study Design: This study assessed glucose levels using the glucose oxidase method in blood and unstimulated saliva in 90 subjects who were divided into 3 equal groups of controlled type 2 diabetes, uncontrolled type 2 diabetes and those without diabetes. Statistical analysis was carried out using one way ANOVA, Post hoc Tukeys tests and Pearson’s correlation coefficient test. Results: Salivary glucose levels were significantly higher in patients with diabetes than controls. There was a significant positive correlation between salivary and plasma glucose levels in patients with diabetes. Conclusions: Glucose concentration in saliva is higher in diabetics but hyperglycemia does not influence salivary glucose levels. Further clarification is required to claim the diagnostic potentials of saliva in diabetes. Key words:Salivary glucose, type 2 diabetes mellitus, blood glucose.

Stimulated and Unstimulated Saliva Glucose Levels in Children Suffer Insulin-Dependent Diabetes Mellitus

“…In our study, there wasn't seen a significant correlation between unstimulated salivary and serum glucose in Type 1 DM. However, some reports indicated that unstimulated salivary glucose correlates with serum glucose in Type 2 DM (24,25,27), which are not in agreement with the result of this study.…”

Dental caries,diabetes mellitus, metabolic control and diabetes duration: A systematic review and meta‐analysis

“…Salivary pH has been studied and proven to reach lower values in diabetic patients compared to healthy individuals . Several factors contribute to this decrease: the low concentration of bicarbonate, the greater accumulation of dental plaque and saliva with high cariogenic load and an increased concentration of salivary glucose, possibly related to microvascular complications (damage to the basal membrane of salivary glands leads to an endothelial dysfunction and the glucose molecule is easily released to the existing saliva) …”

The Evaluation of a Low-Cost Colorimeter for Glucose Detection in Salivary Samples

“…Unlike blood glucose, salivary glucose concentration (SGC) has been studied without a clear cut-off or threshold value for healthy and diabetic individuals. However, several studies support the evidence of higher glucose concentration in diabetic patients as compared with healthy individuals, reporting mean average values of 1.18 ± 0.675 mg/dL [ 33 ], 1.23 ± 0.52 mg/dL [ 40 ] and 79.4 ± 5.8 µM [ 34 ] for SGC in healthy groups. For diabetic groups, mean values of 4.95 ± 2.479 mg/dL [ 33 ], 4.22 mg/dL [ 40 ] and 187.3 ± 20 µM [ 34 ] have been reported.…”

“…Likewise, to replace blood glucose, the analysis of body fluids with glucose content such as tears, urine, sweat and saliva have been proposed as potential non-invasive methods to improve DM monitoring [ 28 , 29 , 30 , 31 ]. Within these, glucose content in saliva has attracted attention given the potential correlation between salivary glucose and blood glucose in diabetic individuals as well as the inherent advantages of saliva samples such as non-invasiveness, cost-effectiveness and ease of collection [ 32 , 33 , 34 ]. However, given the low concentration of salivary glucose, clinical studies to correlate salivary glucose with blood glucose have been carried out with highly sensitive instrumental techniques such as Gas Chromatography [ 35 ] and especially UV-Vis-NIR [ 32 , 34 , 36 , 37 ] which present disadvantages such as high-cost, non-portability and the need for a trained personal for execution.…”