Obtaining a Reliable Diagnostic Biomarker for Diabetes Mellitus by Standardizing Salivary Glucose Measurements

Abstract

Salivary glucose is frequently utilized in diabetes mellitus (DM), and it might be proposed as a potential biomarker candidate for DM, as it is non-invasive and cost-effective and achieves adequate diagnostic performance for DM patients. However, salivary glucose levels may change under specific conditions. It is consequently essential to maintain a consistent strategy for measuring saliva, taking into account the possibility of external factors influencing salivary glucose levels. In this study, we analyzed salivary glucose levels under different handling conditions and donor-dependent factors, including age, interdiurnal variations, and collection and processing methods. A structured questionnaire was used to determine the symptoms and predisposing factors of DM. The glucose oxidase peroxidase method was used to estimate glucose levels in the blood and saliva of people in a fasting state. The aim of this study is to investigate the effect of such conditions on salivary glucose levels. We found that these extraneous variables should be taken into account in the future when salivary glucose is used as a predictive biomarker for DM.

Connections between cross-tissue and intra-tissue biomarkers of aging biology in older adults

“…For DNA methylation measured in saliva, recent evidence suggests that variations seen across cell types, compared to within a cell type, are likely due to variations in immune cell contamination [ 33 , 57 ]. Moreover, saliva composition could be affected by medications use, age, circadian rhythms among other individual-specific exposures, and conditions such as diabetes, multiple sclerosis, liver conditions, and infectious diseases [ 6 , 58 , 59 ]. Therefore, it is important to consider tissue type and method of measurement in biological aging investigations.…”

Recent Advances in Salivary Glucose Monitoring

“…Since saliva glucose concentration is 0.5-1.0 mg/dl, which is more than 1000 times lower than blood, and most saliva-based diagnostic techniques rely on homogeneous saliva in a non-stimulated state, high demands are placed on the collection method and sample standardization. One study found that unstimulated parotid saliva had the highest correlation with blood glucose (R2=0.707) by collecting saliva from 80 healthy individuals by various methods depending on the collection site and whether it was stimulated or not [21]. Enduardo team developed a simplex cotton-paper-syringe filtration system for simple, rapid, and low-cost pretreatment of saliva samples, which significantly reduced the lower limit of detection of glucose in saliva (2.60 × 10-6 mol/L) [22].…”

Saliva sampling strategies affecting the salivary glucose measurement

“…The potential of SGM to revolutionize diabetes management is encouraging as it provides individuals with an easier and less stressful way to monitor their blood sugar levels. [26][27][28][29] While SGM is an emerging non-invasive approach to traditional blood glucose testing, it has some drawbacks that require consideration. 30 One of the primary concerns is the variability in glucose concentrations in saliva, which can be inuenced by several factors such as oral hygiene, diet, and dehydration.…”

“…The potential of SGM to revolutionize diabetes management is encouraging as it provides individuals with an easier and less stressful way to monitor their blood sugar levels. 26–29…”