Saliva diagnostic utility in patients with type 2 diabetes: Future standard method

Abstract

Summary Background The purpose of the present study was to assess saliva reliability in diagnosis and monitoring type 2 diabetes instead of blood. Methods Blood and unstimulated whole saliva were collected from 300 type 2 diabetic subjects and 300 healthy controls in fasting. Then, the salivary flow rate was calculated. All parameters including glucose, urea, amylase, total protein, albumin, C-reactive protein (CRP), immunoglobulin A (IgA), potassium, calcium and chloride were assessed in the supernatant, using an autoanalyzer. Oral exam was conducted by a single examiner on full mouth excluding third molars. Statistical analysis was performed by the SPSS 20.0 version. Results Saliva screening showed that glucose, urea, amylase, total protein, potassium, calcium and chloride were significantly higher in patients compared to controls (p < 0.05). Whereas, the IgA level and salivary flow rate were significantly reduced in patients (p < 0.05). No significant difference was found in albumin and CRP levels (p = 0.05). There was a significant positive correlation between salivary and plasma glucose levels (r = 0.887, and r = 0.900, p < 0.001), as well as, salivary and blood urea (r = 0.586, and r = 0.688, p < 0.001) in patients and controls, respectively. Conclusions From this study, saliva could be suggested as a useful diagnostic tool for type 2 diabetes.

Changes in salivary biomarkers associated with periodontitis and diabetic neuropathy in individuals with type 1 diabetes

“…To date, evidence regarding salivary IgA in diabetes patients is limited and inconclusive. Some studies report significantly higher levels of salivary IgA in diabetes patients compared to those without 20 , while others demonstrated lower salivary IgA secretion rates 21 and concentrations in patients with diabetes 22 . The latter observation is in line with our finding that specifically focuses on type 1 diabetes patients progressing towards neuropathy and presenting a healthy periodontium.…”

“…leptin, insulin, nerve growth factor, IL’s, TNF-α, hepatocyte growth factor, common salivary protein 1, cortisol, lactic acid) have been explored in relationship with diabetes 27 , 30 – 32 , but often provided somewhat conflicting findings due to their various study designs and inclusion of both type 1 and 2 adult diabetic patients. For example, α-amylase enzyme levels were described as either higher 22 , 33 , similar 34 , or decreased 35 in diabetic patients in comparison to healthy individuals. Our adult type 1 diabetic study cohort demonstrated an increased trend in α-amylase, which extends results found in type 1 diabetic children 36 .…”

“…Overall, current literature presents several controversies on saliva biomarkers, as some studies only included diabetic patients with significantly worse oral conditions 20 , lacked descriptions about the type of diabetes 21 , or only compared type 2 DM with healthy subjects 22 . Our study uniquely reports a set of data solely from a type 1 diabetic cohort with and without neuropathy, providing an opportunity to potentially distinguish masked biomarker observations found in type 1 and 2 mixed cohorts.…”

Saliva as a Diagnostic Tool in Oral Diseases

“…Today, the control of diabetes is done with blood tests, which is an invasive method. In saliva, glucose and urea levels are found to be in direct relation with blood levels (44). In diabetic patients, there was also an increase found in the levels of amylase, total protein, and electrolytes such as potassium, calcium and chloride (44,45).…”

Salivary alpha-amylase–biomarker for monitoring type II diabetes

“…Blood analysis in the form of Random, Fasting, or Post Prandial blood glucose levels is considered as the only conventional method to diagnose or monitor the disease. [ 2 ] hemoglobin A1c (HbA 1c ), the glycosylated Haemoglobin provides an accurate estimate of glucose levels in the blood over the past 23 months and helps overcome the inconsistency in records of at-home monitoring. [ 3 ] However, monitoring of blood glucose levels at frequent intervals can cause discomfort and mental trauma to many individuals.…”