ORIGINAL ARTICLE Doppler ultrasonographic assessment of major salivary glands in Type 2 diabetes mellitus patients in correlation with salivary quantity and serum magnesium levels – A cross-sectional study

Abstract

Background: Diabetes mellitus is a multifactorial genetic disorder, and studies have found that it affects the salivary gland function and levels of micronutrients. Objective: Objective of the study was to assess the Doppler ultrasonographic (USG) changes of major salivary glands in patients with Type 2 diabetes mellitus and to correlate it with the quantity of salivary secretion and serum magnesium levels. Methods: A total of 90 patients diagnosed with Type II diabetes mellitus were categorized into three groups of 30 each, namely, Group A (well controlled), Group B (moderately controlled), and Group C (poorly controlled) based on the HbA1c levels and 30 normal individuals were included as controls. Doppler ultrasonography was used to assess the horizontal and vertical dimensions and vascularity of major salivary glands. The measurements were compared with salivary quantity and serum magnesium levels. Results: The mean vertical and horizontal dimensions of parotid glands were 4.1 ± 0.3, 4.2 ± 0.3 cm (Group A), 4.4 ± 0.4, 4 ± 0.5 cm (Group B), 4.7 ± 0.5, 4 ± 0.5 cm (Group C), respectively, and 3.1 ± 0.3, 2.9 ±0.3 cm in controls. The range of mean value of submandibular gland was 2.5 ± 0.3 2.6 ± 0.3 cm (Group A), 2.9 ± 0.3, 2.9 ± 0.3 cm (Group B), and 3 ± 0.1*2.9 ± 0.2 cm (Group C) while 2.7 ± 0.1, 2.5 ± 0.1 cm in controls which was highly significant with P value of < 0.01. The mean values of salivary flow in Groups A, B, C were 0.35 ± 0.15, 0.37 ± 0.16, and 0.2 ± 0.12, respectively, and that of controls were 0.38 ± 0.15 ml/min. Magnesium levels were 1.83 ± 0.3 mg/dl, 1.25 ± 0.32 mg/dl, and 1.13 ± 0.37 mg/dl in Groups A, B, C, respectively, and that of controls were 1.83 ± 0.3 mg/dl. Serum magnesium and salivary flow had highly significant correlation values with ultrasonographic changes in Group C compared with Groups A and B. Conclusion: To conclude, increased HbA1c levels were associated with increased USG measurements of major salivary glands and decreased levels of serum magnesium and salivary flow.

A Cross-Sectional Study on Ultrasonographic Measurements of Parotid Glands in Type 2 Diabetes Mellitus

“…Increased HbA 1C levels were associated with increased ultrasonographic measurements which were in accordance to a study conducted by Rangdhol et al [ 31 ] ( Table 3 ). The reason for this observation could be the fact that HbA 1C level is directly proportional to the hyperglycemic status of diabetes and chronic hyperglycemia leading to the structural changes in salivary gland including acinar hypertrophy and adipose infiltration [ 8 , 16 , 26 ].…”