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      Correlation of salivary glucose, blood glucose and oral candidal carriage in the saliva of type 2 diabetics: A case-control study

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          Abstract

          Objectives:

          To study the correlation between blood glucose levels and salivary glucose levels in type 2 diabetic patients, to study the relationship between salivary glucose levels and oral candidal carriage in type 2 diabetic patients and to determine whether salivary glucose levels could be used as a noninvasive tool for the measurement of glycemic control in type 2 diabetics.

          Study Design:

          The study population consisted of three groups: Group 1 consisted of 30 controlled diabetics and Group 2 consisted of 30 uncontrolled diabetics based on their random nonfasting plasma glucose levels. Group 3 consisted of 30 healthy controls. Two milliliters of peripheral blood was collected for the estimation of random nonfasting plasma glucose levels and glycosylated hemoglobin (HbA1c). Unstimulated saliva was collected for the estimation of salivary glucose. Saliva was collected by the oral rinse technique for the estimation of candidal counts.

          Results:

          The salivary glucose levels were significantly higher in controlled and uncontrolled diabetics when compared with controls. The salivary candidal carriage was also significantly higher in uncontrolled diabetics when compared with controlled diabetics and nondiabetic controls. The salivary glucose levels showed a significant correlation with blood glucose levels, suggesting that salivary glucose levels can be used as a monitoring tool for predicting glycemic control in diabetic patients.

          Conclusion:

          The present study found that estimation of salivary glucose levels can be used as a noninvasive, painless technique for the measurement of diabetic status of a patient in a dental set up. Increased salivary glucose levels leads to increased oral candidal carriage; therefore, oral diagnosticians are advised to screen the diabetic patients for any oral fungal infections and further management.

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            Salivary characteristics of diabetic children

            Salivary components may suffer variations that can be detected by chemical determinations. The aim of this work was to determine physical and biochemical characteristics of the saliva of a group of diabetic children compared to those of a control group. Relation to oral health indices was also determined. Twenty diabetic children (3-15-years-old) and 21 control children (5-12-years-old) were included in this study. Total proteins, sugars and calcium were determined by colorimetric methods, and glucose, urea, alpha-amylase and acid phosphatase by enzymatic methods. Our results demonstrated that acidic pH, diminished salivary flow rate and excess foam are usually present in saliva of diabetic children. Total sugars, glucose, urea and total proteins were greater in diabetic patients than controls, while calcium values were decreased. These differences were confirmed by the discrimination test. Diabetic children have higher DMFT-dmft-deft and DMFS-dmfs-defs values compared to those of the control children despite their lower sugar intake. Some salivary components in addition to the diminished flow rate could be involved in the characterization of the oral health state of diabetic children.
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              Diabetes mellitus as a contributory factor in oral candidosis.

              It has been reported that poor glycaemic control predisposes to oral candidal infection in diabetic patients. For instance, the carriage of Candida species and the density of candidal growth in the oral cavity is frequently claimed to be increased in patients with diabetes mellitus. However, the validity of these observations remains controversial. Hence, we review and discuss here the clinical data in the literature on the relationship between diabetes and oral candidal carriage and infection, and possible mechanisms associated with its pathogenicity.
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                Author and article information

                Journal
                Contemp Clin Dent
                Contemp Clin Dent
                CCD
                Contemporary Clinical Dentistry
                Medknow Publications & Media Pvt Ltd (India )
                0976-237X
                0976-2361
                Jul-Sep 2014
                : 5
                : 3
                : 312-317
                Affiliations
                [1] Department of Oral Medicine and Radiology, Vananchal Dental College and Hospital, Ranchi, Jharkhand, India
                [1 ] Department of Oral Medicine and Radiology, Vydehi Institute of Dental Sciences, Bangalore, Karnataka, India
                Author notes
                Correspondence: Dr. Satish Kumar, House No. 3100, Sector 12/B, Bokaro Steel City - 827 012, Jharkhand, India. E-mail: dr.satish0907@ 123456gmail.com
                Article
                CCD-5-312
                10.4103/0976-237X.137925
                4147805
                25191065
                03eebe3f-540a-4317-830c-dec5fdd933f2
                Copyright: © Contemporary Clinical Dentistry

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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                Categories
                Original Article

                Dentistry
                hba1c,oral candidal carriage,salivary glucose levels,type 2 diabetics,type 2 diabetes mellitus

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