The alterations of whole saliva constituents in patients with diabetes mellitus

Abstract

The present study was undertaken in order to determine the possible alterations in whole saliva and the periodontal status in patients with diabetes mellitus (DM), and was conducted on 17 patients with DM and 17 systemically and periodontally healthy subjects. When the subjects were evaluated clinically, significantly increased probing depths were noticed in the DM group when compared with the healthy subjects. In whole saliva samples, sodium, potassium, total protein, amylase, thiocyanate, and secretory IgA levels were determined in both groups. Difference between the two groups regarding the mean salivary potassium levels were found to be statistically significant since the mean salivary potassium levels in the DM and the control groups were 2.470 +/- 9.04 mmol/L and 14.30 +/- 8.88 mmol/L, respectively. The mean salivary total protein, amylase and secretory IgA levels in the DM group were 2.41 +/- 1.0 mg/mL, 124.2 +/- 79.7 U/mL and 6.86 +/- 3.50 mg/L, all being significantly higher than the control group. However, no significant differences could be shown for the salivary sodium and thiocyanate levels. Nor was there any difference between non-insulin dependent diabetes mellitus (NIDDM) and insulin-dependent diabetes mellitus (IDDM). The findings of the present study suggest that, besides the clinical examinations, the determination of the possible alterations in the composition of whole saliva might also be helpful in understanding the increased severity of periodontal disease in diabetic patients.

Alterations in Whole Saliva Constituents in Patients with Diabetes Mellitus and Periodontal Disease

“…Probing depth in group I (5.2 ± 0.31) was significantly higher than group II (4.28 ± 6.35) and group III (2.21 ± 0.19). These findings were consistent with the findings of Marder et al, 13 Aryeh BH 15 and Yavuzyilmaz et al 8 Our findings confirmed the general hypothesis that the degree of periodontal inflammation was more severe in the diabetic group than group II and group III.…”

“…This in turn increased the accumulation of plaque and calculus resulting in pronounced periodontal inflammation. Our study was in accordance with studies conducted by Sharon et al, 11 Yavuzyilmaz et al, 8 Marder et al 13 and Lindstrom et al 14 7. Probing depth in group I (5.2 ± 0.31) was significantly higher than group II (4.28 ± 6.35) and group III (2.21 ± 0.19).…”

“…These findings were in corroboration with studies conducted by Belting et al, 7 Yavuzyilmaz et al 8 Erhan Firtali1 9 and O'leary et al 10 Our findings clearly indicated that the presence of an underlying systemic disease like diabetes mellitus may lead to initiation or rapid progression of periodontal disease. 1.…”

“…Increased glucose secretion has been attributed to glandular secretary changes and increased glucose secretion in the crevicular fluid which eventually alters the plaque environment leading to the growth of specific microorganisms. 12 In the study by Yavuzyilmaz et al 8 contrary results were obtained which they explained due to hormonal and metabolic changes in diabetes which can significantly affect salivary gland composition and function. 6.…”

“…Modern methods applied to this secretion may provide information that is different from other body fluids. Earlier studies have been conducted using stimulated salivary samples, 11 stimulated whole salivary samples 16 and whole unstimulated salivary samples 8 in an attempt to determine the possible relationship between the altered salivary secretions and mucosal changes occurring subsequent to diabetes mellitus. According to Finney et al, periodontal disease has been considered the 6th 'opathy' associated with diabetes after 'retinopathy', 'nephropathy', 'vasculopathy' and 'peripheral and autonomic neuropathies'.…”