Fasting salivary glucose levels is not a better measure for identifying diabetes mellitus than serum or capillary blood glucose levels: comparison in a Ghanaian population

Ephraim, Richard K.D.; Anto, Enoch Odame; Acheampong, Emmanuel; Fondjo, Linda Ahenkorah; Barnie, Richmond B.; Sakyi, Samuel Asamoah; Asare, Ambrose

doi:10.1016/j.heliyon.2019.e01286

Cited by 10 publications

(9 citation statements)

References 22 publications

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“…Glycated proteins such as HbA1C can be compared with salivary markers, such as serum cortisol levels, salivary cortisol, plasma and prolactin levels [ 9 ], other putative diabetic markers [ 10 ], and the enzyme representing the first glycemic controlling enzyme in food digestion (i.e., salivary amylase) [ 11 ]. Moreover, fast blood glucose and salivary glucose test marks have been correlated significantly in patients with DM [ 12 , 13 ] and there is, in turn, a positive correlation between fast salivary glucose testing and HbA1c [ 12 , 14 ] and other salivary markers, for example, fructosamine glycated protein showed a significant correlation with HbA1c and blood glucose [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

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Changes in Salivary Amylase and Glucose in Diabetes: A Scoping Review

et al. 2021

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Background and Objective: Diabetes mellitus (DM) is a common long-term disease which can be related with salivary amylase levels. DM has recently been associated with salivary amylase diagnostics that could further impair diagnoses in the diabetic population, as well as being an interesting alternative to traditional methods of determine glucose levels. The main advantage of this method is related to the fact that it is a fast diagnostic method. The DM population experiences changes to their metabolism which affects their salivary parameters, making this an alternative procedure for diagnosis and follow-up of the illness due to the non-invasive nature of salivary analyzes. The objective of this review is to summarize the evidence regarding the changes in salivary amylase and glucose levels, and their relationship with blood markers of glycemic control used in clinical settings such as blood glucose and glycated hemoglobin. The differences in salivary amylase levels depending on the method of saliva collection under fasting or non-fasting conditions. The changes in salivary amylase depends on the type of diabetes, the type of insulin treatment or the quality of glycemic control. Conclusions: Salivary amylase concentration is increased in diabetic patients in most of the studies and salivary glucose concentration in all studies in both fasting and non-fasting (post-prandial) conditions. Salivary amylase and glucose concentration represent potential non-invasive biomarkers to evaluate glycemic control and clinical management of diabetic patients, although it is necessary to evaluate the influence of potential modulating factors such as age, duration diseases, sex and the effects of pharmacological treatments in these outcomes which remained to be elucidated.

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Section: Introductionmentioning

confidence: 99%

“…However the predictive value of the salivary glucose test can be modified due to bacterial flora in the mouth [ 15 ], hydration and certain drugs [ 13 ]. For this reason, this diagnosis method should be considered carefully and other salivary biomarkers could be more valid alternatives than glucose determination in saliva [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

Changes in Salivary Amylase and Glucose in Diabetes: A Scoping Review

et al. 2021

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“…Noninvasive saliva collection reduces patient anxiety, promotes more frequent self-monitoring, and enables the disease diagnosis at an early stage [32]. Unfortunately, the assessment of glucose and insulin in the saliva is not diagnostically relevant because it does not reflect their levels in the blood [33][34][35]. Nonetheless, there has been considerable recent interest in saliva-based diagnostics focusing on redox biomarkers.…”

Section: Discussionmentioning

confidence: 99%

Salivary Redox Biomarkers in Insulin Resistance: Preclinical Studies in an Animal Model

Maciejczyk

Pawlukianiec

Żendzian-Piotrowska

et al. 2021

Oxidative Medicine and Cellular Longevity

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Insulin resistance (IR) is a condition of impaired tissue response to insulin. Although there are many methods to diagnose IR, new biomarkers are still being sought for early and noninvasive diagnosis of the disease. Of particular interest in laboratory diagnostics is saliva collected in a stress-free, noninvasive, and straightforward manner. The purpose of the study was to evaluate the diagnostic utility of salivary redox biomarkers in preclinical studies in an animal model. The study was conducted on 20 male Wistar rats divided into two equal groups: a standard diet and a high-fat diet (HFD). In all rats fed the HFD, IR was confirmed by an elevated homeostasis model assessment (HOMA-IR) index. We have shown that IR is responsible for the depletion of the enzymatic (↓superoxide dismutase) and nonenzymatic (↓ascorbic acid, ↓reduced glutathione (GSH)) antioxidant barrier at both the central (serum/plasma) and salivary gland (saliva) levels. In IR rats, we also demonstrated significantly higher concentrations of protein/lipid oxidation (↑protein carbonyls, ↑4-hydroxynoneal (4-HNE)), glycation (↑advanced glycation end products), and nitration (↑3-nitrotyrosine) products in both saliva and blood plasma. Salivary nonenzymatic antioxidants and oxidative stress products generally correlate with their blood levels, while GSH and 4-HNE have the highest correlation coefficient. Salivary GSH and 4-HNE correlate with body weight and BMI and indices of carbohydrate metabolism (glucose, insulin, HOMA-IR) and proinflammatory adipokines (leptin, resistin, TNF-α). These biomarkers differentiate IR from healthy controls with very high sensitivity (100%) and specificity (100%). The high diagnostic utility of salivary GSH and 4-HNE is also confirmed by multivariate regression analysis. Summarizing, saliva can be used to assess the systemic antioxidant status and the intensity of systemic oxidative stress. Salivary GSH and 4-HNE may be potential biomarkers of IR progression. There is a need for human clinical trials to evaluate the diagnostic utility of salivary redox biomarkers in IR conditions.

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“…Studies have focused on finding a correlation between salivary glucose, glycated proteins, and fructosamine with serum markers of diabetes. Indeed, fasting blood glucose and fasting salivary glucose levels correlate significantly with each other in patients with DM (Satish et al 2014; Ephraim et al 2019), in addition to a positive correlation between fasting salivary glucose and HbA 1c (Satish et al 2014). Additionally, evidence suggests that salivary glycated proteins exhibited weak correlation with serum HbA 1c (Rao et al 2015).…”

Section: Introductionmentioning

confidence: 99%

“…Mechanisms that increase glucose in the saliva of hyperglycemic patients are likely due to alterations in the basement membrane permeability of the salivary glands (Kadashetti et al 2015), in addition to alterations in the basement membrane of vessels by the action of glycation by-products that form a complex with extracellular proteins (Patel et al 2015). It is important to note that the predictive accuracy of fasting salivary glucose on the glycemic status of DM patients can be influenced by factors such as bacterial degradation of salivary glucose (Nakamoto et al 2003), water intake, mood, and diabetes medications (Ephraim et al 2019), which raises the question of whether salivary protein glycosylation can be considered a reliable biomarker of recent hyperglycemia (7- to 21-d blood glucose) (Rao et al 2015).…”

Section: Introductionmentioning

confidence: 99%

Salivary Fructosamine as a Noninvasive Glycemic Biomarker: A Systematic Review

Khoury

Illesca

Sultan

2020

JDR Clinical & Translational Research

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Background: Standard diagnostic and monitoring methods for glycemic status involve invasive sample collection through venous puncture or fingerstick. Recent attention has been focused on exploring noninvasive methods through oral biofluids. Specifically, serum fructosamine has been established as a short-term (2- to 3-wk) marker of disease status in patients with diabetes. Fructosamine measured through noninvasive means such as saliva has shown promise, but its clinical applicability is unknown. Objective: Evaluate the available evidence on using salivary fructosamine as a reliable noninvasive marker to screen and diagnose patients with diabetes mellitus in the clinical setting. A comparative analysis of the correlative accuracy of salivary fructosamine measurements with established blood glycemic biomarkers such as serum fructosamine, blood glucose, and HbA1c will be conducted. Methods: Six electronic databases (PubMed, PubMed Central, MEDLINE, EMBASE, Scopus, Cochrane Library) were searched for original research papers (clinical and animal studies) that were relevant to the objective of this systematic review. The search was initiated on May 28, 2020. The systematic review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Bias risk assessment, overall quality, and level of evidence were based on the Oxford Centre for Evidence-Based Medicine, Appraisal Tool for Cross-Sectional Studies, and Collaborative Approach to Meta-Analysis and Review of Animal Data from Experimental Studies tool. Heterogeneity was assessed using the National Institutes of Health quality assessment tool for cross-sectional studies. Results: A total of 174 records were identified. Full-text articles screened for eligibility (n = 21) identified only 6 original research articles relevant to the research question and were thus included in the systematic review. The types of studies identified were cross-sectional and in vivo studies. Three studies (3/6) showed positive correlation of salivary fructosamine with blood glucose levels, while 1 study (1/6) demonstrated a positive correlation with glycated hemoglobin (HbA1c). Limitations related to sample size and selection were identified along with a fair level of interstudy heterogeneity. Conclusion: Based on the evidence evaluated, the utility of salivary fructosamine as a noninvasive marker to screen and diagnose patients with diabetes is doubtful. The overall level of evidence was low (IIIB) and the risk of bias was determined to be high. Knowledge Transfer Statement: Further evidence in the form of large-scale well-controlled studies is needed prior to recommending salivary fructosamine as a noninvasive diagnostic tool for glycemic status in patients with diabetes mellitus.

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Fasting salivary glucose levels is not a better measure for identifying diabetes mellitus than serum or capillary blood glucose levels: comparison in a Ghanaian population

Cited by 10 publications

References 22 publications

Changes in Salivary Amylase and Glucose in Diabetes: A Scoping Review

Changes in Salivary Amylase and Glucose in Diabetes: A Scoping Review

Salivary Redox Biomarkers in Insulin Resistance: Preclinical Studies in an Animal Model

Salivary Fructosamine as a Noninvasive Glycemic Biomarker: A Systematic Review

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