Tuesday , November 21 2017
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Saliva A Marker for Type 2 Diabetes

Saliva may be a marker for both periodontal disease activity and hyperglycemia in uncontrolled type 2 diabetes, according to new research. Carol W. Bassim, DMD, doctor of medical dentistry, research fellow, National Institutes of Health, Bethesda, Maryland, United States, noted that saliva holds much potential as a marker for disease in periodontitis and type 2 diabetes.

"We are seeing that saliva may be a way to check for periodontal disease and diabetes, more than is serum," said Dr. Bassim. "We know that inflammation and infection in periodontal disease is associated with poorly controlled type 2 diabetes."

Investigators prospectively studied subjects who presented with either severe periodontitis or moderate periodontal disease. All had uncontrolled type 2 diabetes. Specifically, they were measuring salivary procalcitonin (ProCT) correlated with diabetic glucose control.

"We know that if you get septic, for instance, and have severe systemic inflammation or infection, the degree of procalcitonin is significantly increased," said Dr. Bassim.

Dr. Bassim and colleagues collected samples of non-stimulated whole saliva through expectoration from 22 patients with periodontitis with uncontrolled type 2 diabetes; their HgbA1C exceeded 7.0. They also conducted a complete periodontal examination and collected serum from each subject.

Researchers discovered salivary-ProCT correlated with bleeding-on-probing, bleeding that indicates active periodontal disease (r=0.50, P =.03, n=18). In addition, salivary-ProCT was correlated with HgbA1c in each patient, at baseline measurements and at a three-month follow-up visit (r=0.43, P =.01, n=33).

Investigators found periodontal indicators were not directly correlated with HgbA1c. Moreover, serum levels of ProCT were not correlated with either periodontal indicators or glucose control. Serum levels of ProCT were decreased compared to that of saliva: mean 92 vs. 246 pg/ml. "Salivary amounts seem to matter more than serum," observed Dr. Bassim.

Future research may lead to the potential for a salivary biomarker of both periodontitis and poorly controlled type 2 diabetes, according to Dr. Bassim.

"There is no quick and easy test for periodontitis," said Dr. Bassim. "It would be a wonderful thing to have a biomarker like saliva in that sense. For endocrinologists, it would be a quick and easy way to look at HbA1c values in a clinical setting and track those values."

Presented at the annual 89th meeting of the Endocrine Society (ENDO). [Presentation title: Procalcitonin: A Salivary Biomarker for Periodontal Disease Activity and Hyperglycemia in Uncontrolled Type II Diabetes. Abstract P2-231]

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FACT:

Black patients as compared to white patients were less likely to die within the first 30 days after a heart attack, but they were more likely to die thereafter, no matter what type of hospital they were initially treated at.  These differences do not seem to be related to geographic access to specialized heart services because black patients were less likely to receive these services regardless of what type of hospital they were treated at.  In other words, it’s not a matter of where you go in this case, it’s a matter of what happens after you get there.  Ioana Popescu, M.D., M.P.H.University of Iowa