Abstract
Diabetes is a major cause of mortality and morbidity. However, a large percentage of diabetics live without being diagnosed.9 The early diagnosis of diabetes can prevent early, long - term complications that are responsible for the high morbidity of diabetics. This major global risk is predicted to cause substantial financial loss due to increased health care expenditure and lost productivity.10 This makes the primary prevention of diabetes and its complications, of paramount importance. It is known that diabetes affects salivary composition and function.8This study was done to examine the effect of age on salivary and blood glucose levels in type II diabetics. Salivary and blood glucose levels were estimated and compared in both groups. The eighty adults included in our study belonged to the age group of 30 - 50 years and were divided into 2 groups - diabetics and healthy adults. Both groups were further divided into 4 groups based on age (30-35, 36-40, 41-45, 46-50 years). Blood samples were obtained from subjects after an overnight fast and 2 hours postprandial and analysed with hexokinase enzyme using an automated analyser. Saliva samples obtained from subjects after an overnight fast and 2 hours postprandial were assessed with glucose oxidase enzyme using a colorimeter. Salivary glucose levels were compared between diabetics and healthy adults by t-test. Relationship between salivary and blood glucose was assessed by correlation test. Difference in salivary and blood glucose levels between age groups was determined by Kruskal-Wallis test. Salivary glucose is significantly higher in diabetics (P<0.001). Correlation flanked by salivary and blood glucose is not seen. Further studies will help in use of salivary diagnostics for early and non-invasive diagnosis of diabetes. Blood glucose is highest in 36-40 years and salivary glucose in 46-50 years age group. There is a temporal shift in the age of diagnosis of diabetes.
Keywords: Diabetes mellitus; age; blood glucose; salivary glucose.
References
- American Diabetes Association (2011) Diagnosis and classification of diabetes mellitus. Diabetes Care 34: S62–9.
- The International Expert Committee (2009) International Expert Committee Report on the Role of the A1C Assay in the Diagnosis of Diabetes. Diabetes Care 32: 1327–1334.
- Inoue M, Inoue K, Akimoto K. Effects of age and sex in the diagnosis of type 2 diabetes using glycated haemoglobin in Japan: the Yuport Medical Checkup Centre study. PloS one. 2012 Jul 5;7(7):e40375.
- Heianza Y, Hara S, Arase Y, Saito K, Tsuji H, et al. (2012) Impact of introducing HbA1c into the diagnostic criteria on prevalence and cardiovascular risk profiles of individuals with newly diagnosed diabetes in Japan: The Toranomon Hospital Health Management Center Study 2 (TOPICS 2). Diabetes Res Clin Pract 95: 283–290.
- Lipska KJ, De Rekeneire N, Van Ness PH, Johnson KC, Kanaya A, et al. (2010) Identifying dysglycemic states in older adults: implications of the emerging use of hemoglobin A1c. J Clin Endocrinol Metab 95: 5289–5295.
- Selvin E, Coresh J, Brancati FL (2006) The burden and treatment of diabetes in elderly individuals in the U.S. Diabetes Care 29: 2415–2419.
- Motta M, Bennati E, Ferlito L, Malaguarnera M (2006) Diabetes mellitus in the elderly: diagnostic features. Arch Gerontol Geriatr 42: 101–106.
- Panchbai AS, Degwekar SS, Bhowte RR. Estimation of salivary glucose, salivary amylase, salivary total protein and salivary flow rate in diabetics in India. J Oral Sci. 2010;52 (3):359-368.
- International Diabetes Federation [homepage on the Internet]. c2017 [updated 2017; cited 2017] Available from: www.idf.org
- Dodds MW, Johnson DA, Yeh CK. Health benefits of saliva: a review. J Dent.2005 Mar;33 (3):223-33.
- Powers AC. Diabetes mellitus: Management and Therapies. In: Fauci A, Kasper D, Hauser S, editors. Harrison’s principles of internal medicine. New York: McGraw-Hill, 2015; p. 2407–2422.
- Powers AC. Diabetes mellitus: Complications. In: Fauci A, Kasper D, Hauser S, editors. Harrison’s principles of internal medicine. New York: McGraw-Hill, 2015; p. 2422–2430
- Chan JC, Malik V, Jia W, Kadowaki T, Yajnik CS, Yoon KH, et al. Diabetes in Asia: epidemiology, risk factors and pathophysiology. JAMA. 2009;301 (20):2129-2140.
- Satish BN, Srikala P, Maharudrappa B, Awanti SM, Kumar P, Hugar D. Saliva: A tool in assessing glucose levels in Diabetes Mellitus. J Int Oral Health. 2014; 6(2):114-117.
- Ramachandran A, Mary S, Yamuna A, Murugesan N, Snehalatha C. High prevalence of Diabetes and cardiovascular risk factors associated with urbanization in India. Diabetes Care. 2008 May;31 (5):893-8.
- Panchbai AS, Degwekar SS, Bhowte RR. Estimation of salivary glucose, salivary amylase, salivary total protein and salivary flow rate in diabetics in India. J Oral Sci. 2010;52 (3):359-368.
- Sariri R, Varasteh A, Erfani A. Alternations in salivary glucose during ramadan fasting. Sci Res. 2010;2 (7): 769-772.
- Vasconcelos AC, Soares MS, Almedia PC, Soares TC. Comparative study of the concentration of salivary and blood glucose in type 2 diabetic patients. J Oral Sci. 2010;52 (2):293-8.
- Belazi MA, Galli – Tsinopoulou A, Drakoulakos D, Fleva A, Papanayiotou PH. Salivary alterations in insulin – dependent diabetes mellitus. Int J Paediatr Dent. 1998 Mar;8 (1):29-33.
- Gupta S, Sandhu SV, Bansal H, Sharma D. Comparison of salivary and serum glucose levels in diabetic patients. Journal of diabetes science and technology. 2014 Oct 7;9(1):91-6.
- Harris MI, Cowie CC, Howie LJ. American Diabetes Association consensusstatement on self-monitoring of blood glucose. Diabetes Care. 1987;10:95-9.
- Mohan V, Sandeep S, Deepa R, Shah B, Varghese C. Epidemiology of type 2 diabetes: Indian scenario. The Indian journal of medical research. 2007 Mar 1;125(3):217-30.
- Dickinson S, Colagiuri S, Faramus E, Petocz P, Brand-Miller JC. Postprandial hyperglycemia and insulin sensitivity differ among lean young adults of different ethnicities. J Nutr. 2002;132 (9):2574-2579.
- Hu FB. Globalization of diabetes: the role of diet, lifestyle, and genes. Diabetes Care. 2011 Jun;34 (6):1249-57.
- Ganong WF. Endocrine functions of the pancreas and regulation of carbohydrate metabolism. In: Barrett KE, Barman SM, Boitano S, Brooks HL, editors. Review of Medical Physiology, 25th New York: McGraw-Hill, 2015; p. 429-449
- Darwazeh AM, MacFarlane TW, McCuish A, Lamey PJ. Mixed salivary glucose levels and candidal carriage in patients with diabetes mellitus. Journal of Oral Pathology & Medicine. 1991;20:280–283.
- Murrah VA, Crosson JT, Sauk JJ. Parotid gland basement membrane variation in diabetes mellitus. J Oral Pathol. 1985 Mar;14 (3):236-46.
- Babu NA, Masthan KM, Bhattacharjee T, Elumalai M. Saliva-the key regulator of oral changes in diabetes patients. IJPSR. 2014;5 (7):2579-2583.
- IvanovskiK, Naumovski V, Kostadinova M, Pesevska S, Drijanska K, Filipce V. Xerostomia and salivary levels of glucose and urea in patients with diabetes. Prilozi Macedonian Academy of Sciences and Arts, Section of Biological and Medical Sciences. 2012;33 (2):219.
- Navalkar A, Bhoweer A. Alterations in whole saliva constituents in patients with diabetes mellitus and periodontal disease. JIAOMR. 2011;23 (4):498-501
- Vaziri PB, Vahedi M, Mortazavi H, Abdollahzadeh S, Hajilooi M. Evaluation of salivary glucose, IgA and flow rate in diabetic patients: a case-control study. Journal of dentistry (Tehran, Iran). 2010;7 (1):13-8.
- McAdams MA, Van Dam RM, Hu FB. Comparison of self-reported and measured BMI as correlates of disease markers in U.S. adults. Obesity. 2007;15:188.
- Zhang W, Wang ML, inventors; Northeastern University., assignee. Saliva glucose monitoring system. United States patent Jul 7.
- Mucci DA, Clark RG, Fox JS, inventors; Quick Technologies., assignee. Mobile smart device infrared light measuring apparatus, pimethod, and system for analyzing substances. United States patent 2014 Jan 30.
- Ahmed AF, Fayed MS, Yasser MH, Lincz LF. Retrospective study among primary care Type 2 diabetes mellitus patients within the city of Zliten, Libya, represented high incidence of early onset of disease diagnosis. Libyan Journal of Medical Sciences. 2019 Jan 1;3(1):13.
- TODAY Study Group. A clinical trial to maintain glycemic control in youth with type 2 diabetes. New England Journal of Medicine. 2012 Jun 14;366(24):2247-56.
- Fall CH, Kumaran K. Metabolic programming in early life in humans. Philosophical Transactions of the Royal Society B. 2019 Feb 25;374(1770): 20180123.
- Dhawan D, Sharma S. Metabolic syndrome: The bane of Indian population.
Corresponding Author
Dr S. Srikanth
Associate Professor, Department of Physiology, Kempegowda Institute of Medical Sciences, Bangalore, Karnataka – 560070, India
DOI: https://dx.doi.org/10.18535/jmscr/v7i7.84
