Estimation of gingival crevicular blood glucose level for the screening of diabetes mellitus: A simple yet reliable method

Parihar, Sarita; Tripathi, Richik; Parihar, Ajit Vikram; Chandra, Akhilesh; Bhavsar, Neeta

doi:10.1016/j.jobcr.2016.05.004

Cited by 15 publications

(11 citation statements)

References 22 publications

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“…Our data extend previous findings using the same study design that have documented successful blood glucose evaluation in undiagnosed diabetic patients and diabetic population. Interest in the detection of diabetes using GCB has been heightened by the results of several trials for the treatment of periodontal patients [ 7 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ]. Of course, the optimal condition for GCB measurement occurs when the bleeding is abundant.…”

Section: Discussionmentioning

confidence: 99%

Gingival Crevicular Blood as a Potential Screening Tool: A Cross Sectional Comparative Study

Rapone

Ferrara

Santacroce

et al. 2020

IJERPH

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Background: Diabetes is known to be one of the major global epidemic diseases, significantly associated with mortality and morbidity worldwide, conferring a substantial burden to the health care system. The epidemiological transition of this chronic disease tends to worsen unless preventive health strategies are implemented. Appropriate screening devices and standardized methods are crucial to prevent this potentially inauspicious life condition. Currently, the glucometer is the conventional device employed for blood glucose level determination that outputs the blood glucose reading. Glucometer performed in the dental office may be an important device in screening diabetes, so it can be addressed during a periodontal examination. Because gingival blood is a useful source to detect the glucose level, the focus is placed on the opportunity that might provide valuable diagnostic information. This study aimed to compare gingival crevicular blood with finger-stick blood glucose measurements using a self-monitoring glucometer, to evaluate whether gingival crevicular blood could be an alternative to allow accurate chairside glucose testing. Methods: A cross-sectional comparative study was performed among a 31–67-year-old population. Seventy participants with diagnosed type 2 diabetes and seventy healthy subjects, all with positive bleeding on probing, were enrolled. The gingival crevicular blood was collected using a glucometer to estimate the blood glucose level and compared with finger-stick blood glucose level. Results: The mean capillary blood glucose and gingival crevicular blood levels from all samples were, respectively, 160.42 ± 31.31 mg/dL and 161.64 ± 31.56 mg/dL for diabetic participants and 93.51 ± 10.35 mg/dL and 94.47 ± 9.91 mg/dL for healthy patients. In both groups, the difference between gingival crevicular blood and capillary blood glucose levels was non-significant (P < 0.05). The highly significant correlation between capillary blood glucose and gingival crevicular blood (r = 0.9834 for diabetic patients and r = 0.8153 for healthy participants) in both the groups was found. Conclusions: Gingival crevicular blood test was demonstrated as a feasible and useful primary screening tool test for detecting diabetes and for glucose estimation in non-diabetic patients. Use of gingival crevicular blood for screening is an attractive way of identifying a reasonable option of finger-stick blood glucose measurement under the appropriate circumstances. Rapid assessment may precede diagnostic evaluation in diabetic as well as healthy patients with acute severe bleeding. In addition, gingival crevicular blood levels may be needed to monitor the diabetic output.

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Section: Discussionmentioning

confidence: 99%

Gingival Crevicular Blood as a Potential Screening Tool: A Cross Sectional Comparative Study

Rapone

Ferrara

Santacroce

et al. 2020

IJERPH

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show abstract

“…Since glucose levels in venous blood obtained by a finger stick and in blood in the gingival crevicular space between the tooth and the gingiva are strongly correlated, it has been suggested to use the latter as a less intrusive method for screening for hyperglycemia [132].…”

Section: 2mentioning

confidence: 99%

IDF Diabetes Atlas: Diabetes and oral health – A two-way relationship of clinical importance

Borgnakke

2019

Diabetes Research and Clinical Practice

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The current scientific evidence for the bi-directional associations between oral health and diabetes is summarized. The universal biologic mechanisms and demographic and behavioral risk drivers underlying these associations in both directions are also described. Dysglycemia, even slightly elevated blood sugar levels, adversely affects oral health, manifesting itself in several oral diseases and conditions. In the opposite direction, any oral infection with its subsequent local and systemic inflammatory responses adversely affects blood glucose levels. Moreover, painful, mobile, or missing teeth may lead to intake of soft food items representing a sub-optimal diet and hence poor nutrition, and thereby contribute to incident type 2 diabetes or to poorer glucose control in existing diabetes. Treatment of inflammation related oral conditions, such as non-surgical periodontal treatment and extraction of infected teeth, can lead to a clinically significant decrease in blood glucose levels. Attention to infectious oral diseases and referral to dental care professionals for treatment can therefore be an important novel tool for medical care professionals in preventing and managing diabetes mellitus. Dental professionals can detect unrecognized potential dysglycemia and refer for medical examination. Such interprofessional, patient centered care may contribute to improved health, wellbeing, and quality of life in people with diabetes.

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“…The search identified 1887 articles after the removal of duplicates; title and abstract search excluded 1823 records due to nonrelevance, 64 were selected for full-text review, and 41 were excluded as they did not meet the study requirements. Of the 23 records assessed for eligibility, 12 [ 2 – 4 , 9 , 10 , 12 , 13 , 31 – 35 ] did not report the diagnostic test results and another two [ 6 , 36 ] used PoC screening with reagent strips that use colour coding to identify the risk of T2DM. The remaining nine studies were included in the analysis.…”

Section: Resultsmentioning

confidence: 99%

“…Centralised laboratory testing does not represent a convenient process for the patient, often requiring more than one visit. Patient-centred healthcare is becoming a global trend and is based on the foundation that health care should be organized closer to the consumer rather than the providers [ 11 – 13 ]. Point of care (PoC) denotes testing done close to the patients.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Undiagnosed Diabetes and Prediabetes in the Dental Setting: A Systematic Review and Meta-Analysis

Chinnasamy

Moodie

2020

International Journal of Dentistry

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Background. With the close link between diabetes mellitus (DM) and periodontal disease (PD), dentists have an unrealized opportunity to make a chance discovery of a patient’s medical condition. Unlike in the medical setting, information on the point of care (PoC) and opportunistic screening for DM in the dental setting is limited. To make a reliable estimate on the prevalence of undiagnosed type 2 diabetes mellitus (T2DM) and prediabetes among dental patients in the dental setting and to assist healthcare planners in making an informed decision, information on the disease frequency and strategies employed to address this issue is of paramount importance. Objectives. To summarize the data on the prevalence of undiagnosed T2DM and prediabetes amongst dental patients and further explore the effectiveness of the PoC screening and its implication for use in the dental setting. Methods. A MEDLINE-PubMed, EMBASE, Web of Science, and Cochrane Library search was conducted with no time specification. Information on study characteristics and diagnostic parameters was retrieved for meta-analysis. All the studies were assessed for methodological quality using the QUADAS-2 tool. Proportions were presented in tables and forest plots. All statistical analysis was performed using the MedCalc software. Results. Nine studies met the inclusion criteria. The proportion of dental patients identified to be at a risk of hyperglycaemia with the PoC screening using random blood glucose (RBG) and HbA1 was 32.47% and 40.10%, whilst the estimated proportion with undiagnosed T2DM and prediabetes was identified as 11.23% and 47.38%. Conclusion. A significant proportion of dental patients can be identified as undiagnosed T2DM and prediabetes. Targeted opportunistic screening is a feasible approach and can help reduce the prevalence of undiagnosed T2DM and prediabetes.

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Estimation of gingival crevicular blood glucose level for the screening of diabetes mellitus: A simple yet reliable method

Cited by 15 publications

References 22 publications

Gingival Crevicular Blood as a Potential Screening Tool: A Cross Sectional Comparative Study

Gingival Crevicular Blood as a Potential Screening Tool: A Cross Sectional Comparative Study

IDF Diabetes Atlas: Diabetes and oral health – A two-way relationship of clinical importance

Prevalence of Undiagnosed Diabetes and Prediabetes in the Dental Setting: A Systematic Review and Meta-Analysis

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