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VOLUME 5 , ISSUE 2 ( July-December, 2017 ) > List of Articles

ORIGINAL RESEARCH ARTICLE

A comparative study on estimation of salivary pH as a screening tool for identifying early neural dysfunction in type 2 diabetes

Anbuselvi Mattuvar Kuzhali S, C. Hemachandrika, Vishwanatha Rao B, Anand Moses CR

Keywords : autonomic dysfunction, salivary pH, Type 2 Diabetes mellitus

Citation Information : S AM, Hemachandrika C, B VR, CR AM. A comparative study on estimation of salivary pH as a screening tool for identifying early neural dysfunction in type 2 diabetes. 2017; 5 (2):26-34.

DOI: 10.5005/NJP-11056-05_02_06

License: CC BY-NC 4.0

Published Online: 01-12-2017

Copyright Statement:  Copyright © 2017; NA


Abstract

Background: Human saliva is a viscoelastic fluid and its secretion is basically a neurally regulated mechanism. Its flow and composition depends on the functional integrity of the nerves supplying the gland. Salivary testing works by placing an acid stress in the mouth to see if a person adapts a healthy alkaline response. Aim:: Our study aims at identifying the early autonomic neuropathic changes in diabetes by evaluating salivary pH. The objectives were to study the change in pH of salivary secretion following an acid challenge (vitamin-c) between diabetics and controls, to correlate the magnitude of change in salivary pH with diabetic neuropathy and fasting blood glucose and to assess the influence of duration of diabetic illness on change in salivary pH. Materials and methods: 82 diabetic patients and 82 age-sex matched controls were tested for salivary pH before and after oral administration of vitamin-C. The change in salivary pH, fasting blood glucose level, duration of diabetes along with clinical manifestation of neuropathy were noted. Data were analyzed using SPSS. Results: The resting salivary pH of the diabetic and control were same. Magnitude of change in salivary ph following an acid challenge in diabetic were significantly less (p<0.001). Longer the duration of diabetes lesser is the the magnitude of change in salivary pH to an acid stress. Conclusion: A significant decrease in stimulated salivary pH following vitamin-C challenge in diabetics implies decreased salivary secretion due to autonomic blunting in diabetic patients.

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  1. Keenan HA, Costacou T, Sun JK, Doria A, Cavellerano J, Coney J, Orchard TJ, Aiello LP, King GL, et al. Clinical factors associated with resistance to microvascular complications in diabetic patients of extreme disease duration: the 50-year medalist study. Diabetes Care. 2007; 30:1995-1997.
  2. Gabbay KH, et al. Hyperglycemia, polyol metabolism, and complications of diabetes mellitus. Annu Rev Med. 1975; 26:521-536.
  3. Ewing DJ, et al. Cardiovascular reflexes and autonomic neuropathy. Clin Sci Mol Med. 1978; 55:321-7.
  4. Harris M. I, Klein R, Welborn T. A, Knuiman M. W, et al. Onset of NIDDM occurs at least 4-7 yr before clinical diagnosis. Diabetes Care. 1992; 15(7):815-9.
  5. Old W. M, Meyer-Arendt K, Aveline-Wolf L, Pierce K. G, Mendoza A, Sevinsky J. R, Resing K. A, Ahn N. G, et al. Comparison of label-free methods for quantifying human proteins by shotgun proteomics. Mol. Cell. Proteomics. 2005; 4(10):1487-502.
  6. Liu H, Sadygov R. G, Yates J. R, et al. A model for random sampling and estimation of relative protein abundance in shotgun proteomics. Anal. Chern. 2004; 76(14):4193-201.
  7. Zybailov B, Coleman M. K, Florens L, Washburn M. P, et al. Correlation of relative abundance ratios derived from peptide ion chromatograms and spectrum counting for quantitative proteomic analysis using stable isotope labeling. Anal. Chem. 2005; 77(19):6218-24.
  8. Zybailov B, Mosley A.L, Sardiu M.E, Coleman M.K, Florens L, Washburn M.P, et al. Statistical analysis of membrane proteome expression changes in Saccharomyces cerevisiae. J. Proteome Res. 2006; 5(9):2339–47.
  9. Pang J.X, Ginanni N, Dongre, A. R, Hefta S.A, Opitek GJ, et al. Biomarker discovery in urine by proteomics. J. Proteome Res. 2002; l(2):161-9.
  10. Fernandez-Real, J. M.; Pickup, J. C, et al. Innate immunity, insulin resistance and type 2 diabetes. Trends Endocrinol. Metab. 2008; 19 (l):10–6.
  11. Hong C.Y, Chia K.S, et al. Markers of diabetic nephropathy. J. Diabetes Complications. 1998; 12(1):43–60.
  12. Meijer JWG, Smit AJ, Sonderen EV, Groothoff JW, Eisma WH, Links TP, et al. Symptom scoring systems to diagnose distal polyneuropathy in diabetes: the Diabetic Neuropathy Symptom score. Diabet Med. 2002; 19:962-5. 5.
  13. Meijer JW, Sonderen EV, Blaauwwiekel EE, Links TP, Groothoff JW, Eisma WH, et al. Diabetic Neuropathy Examination: a hierarchical scoring system to diagnose distal polyneuropathy in diabetes. Diabetes Care. 2000; 23:750-3.
  14. S.P. Humphrey, R.T. Williamson, et al. A review of saliva: normal composition, flow, and function. J. Prosthet. Dent. 2001; 85:162.
  15. Ben-Aryeh H, Serouya R, Kanter Y, Szargel R, Laufer D, et al. Oral health and salivary composition in diabetic patients. J. Diabetes Complications. 1993; 7:57-62
  16. Moore P.A, Guggenheimer J, Etzel K.R, Weyant RJ, Orchard T, et al. Type 1 diabetes mellitus, xerostomia, and salivary flow rates. Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod. 2001; 92:281-291
  17. Siudikiene J, Machiulskiene V, Nyvad B, Tenovuo J, Nedzelskiene I, et al. Dental caries and salivary status in children with type 1 diabetes mellitus, related to the metabolic control of the disease. Eur. J. Oral Sci. 2006; 114:8-14
  18. Lo'pez M.E, Colloca M.E, Pa ez R.G, Schallmach J.N, Koss M.A, hervonagura A, et al. Salivary characteristics of diabetic children. Braz. Dent. J. 2003; 14:26-31
  19. The Diabetes Control and Complications Trial Research Group: The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993; 329:977-986.
  20. Miralles-Jorda L, Silvestre-Donat FJ, Grau Garcia-Moreno DM, Hernandez-Mijares A, et al. Buccodental pathology in patients with insulin-dependent diabetes mellitus: a clinical study. Med Oral. 2002; 7:298-302.
  21. Carda C, Carranza M, Arriaga A, Diaz A, Peydro A, Ferraris ME, et al. Structural differences between alcoholic and diabetic parotid sialosis. Med Oral Patol Oral Cir Bucal. 2005; 10:309-14.
  22. Alemzadeh R, Wyatt DT. Diabetes mellitus. In: Kliegman RM, Behrman RE, Jensen HB, Stanton BF, eds. Nelson textbook of pediatrics. 17th ed. Philadelphia: W.B. Saunders; 2003. p. 1947-1972.
  23. Tenovuo J, Alanen P, Larjava H, Viikari J, Lehtonen OP, et al. Oral health of patients with insulin-dependent diabetes mellitus. Scand J Dent Res. 1986; 94:338-346.
  24. Sreebny LM, Valdini A, et al. Xerostomia: Relationship to other oral symptoms and salivary gland hypofunction. Oral Surg Oral Med Oral Pathol. 1988; 66:451-458.
  25. Reznick AZ, Shehadeh N, Shafir Y, Nagler RM, et al. Free radicals related effects and antioxidants in saliva and serum of adolescents with type 1 diabetes mellitus. Arch Oral Biol. 2006; 51:640-648.
  26. Karjalainen KM, Knuuttila ML, Kaar ML, et al. Salivary factors in children and adolescents with insulin-dependent diabetes mellitus. Pediatr Dent. 1996; 18:306-311.
  27. Fox PC, Busch KA, Baum BJ, et al. Subjective reports of xerostomia and objective measures of salivary gland performance. J Am Dent Assoc. 1987; 115:581-584.
  28. Flink H, Tegelberg A, Lagerlof F, et al. Influence of the time of measurement of unstimulated human whole saliva on the diagnosis of hyposalivation. Arch Oral Biol. 2005; 50:553-559.
  29. Dawes C, et al. Salivary flow patterns and the health of hard and soft oral tissues. J Am Dent Assoc. 2008; 139(Suppl):18S-24S.
  30. Siudikiene J, Machiulskiene V, Nyvad B, Tenovuo J, Nedzelskiene I, et al. Dental caries and salivary status in children with type 1 diabetes mellitus, related to the metabolic control of the disease. Eur J Oral Sci. 2006; 114:8-14.
  31. Lopez ME, Colloca ME, Paez RG, Schallmach JN, Koss MA, Chervonagura A, at al. Salivary characteristics of diabetic children. Braz Dent J. 2003; 14:26-31.
  32. Swanljung O, Meurman JH, Torkko H, Sandholm L, Kaprio E, Maenpaa J, et al. Caries and saliva in 12-18-year-old diabetics and controls. Scand J Dent Res. 1992; 100:310-313.
  33. Navazesh M, Kumar SK, et al. Measuring salivary flow: challenges and opportunities. J Am Dent Assoc. 2008; 139(Suppl):35S-40S.
  34. Navazesh M, Christensen C, Brightman V. Clinical criteria for the diagnosis of salivary gland hypofunction. J Dent Res. 1992; 71:1363-1369.
  35. Reuterving CO, Reuterving G, Hagg E, Ericson T, et al. Salivary flow rate and salivary glucose concentration in patients with diabetes mellitus influence of severity of diabetes. Diab Metab. 1987; 13:457-62.
  36. Dodds MW, Dodds AP, et al. Effects of glycemic control on saliva flow rates and protein composition in non-insulin-dependent diabetes mellitus. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1997; 83:465-70.
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