Salivary flow rate and xerostomia in patients with type I and II diabetes mellitus

Authors

  • Atena Shirzad DDS, MS, Oral Medicine, Assistant Professor, Department of Oral Medicine, Faculty of Dentistry, Babol University of Medical Sciences, Babol, Iran

Keywords:

Xerostomia, Salivary flow rate, Diabetes mellitus

Abstract

Background: Diabetes mellitus is one of the most prevalent metabolic diseases, with complications such as decreased salivary flow rate and xerostomia. 

Objective: This study aimed to determine the salivary flow rate and xerostomia in type I and II diabetic patients in comparison with healthy controls. 

Methods: This case-control study was performed on diabetic patients of a private office in Babol, Iran, between May 2015 and October 2016. This study involved two study groups (type I and II diabetes, with 40 in each group) and two control groups (control I and II, with 35 in each group) which were age- and sex-matched with the related study groups. They were all selected through simple sampling. Unstimulated whole saliva was collected through Navazesh method and the salivary flow rate was measured (ml/min). Xerostomia was evaluated via Fox’s test. Moreover, the patients’ data were recorded including age, sex, disease duration, type of diabetes, fasting blood glucose (FBG) and HbA1C. The obtained data were statistically analyzed by using SPSS version 17. Independent-samples t-test, Chi-square, Pearson correlation and multiple comparison post-hoc tests were employed as appropriated. p<0.05 was considered significant.

Results: The mean salivary flow rate in type I diabetics (0.35±0.11 ml/min) was lower than that in control I (0.50±0.07 ml/min) (p=0.01). The same difference was observed between type II diabetics (0.37±0.13 ml/min) and control II groups (0.47±0.11 ml/min) (p=0.01). No significant difference was observed in the salivary flow rate between type I and II diabetics (p=0.345). Furthermore, xerostomia was higher in type I (2.70±2.50, 1.17±1.60) and II (2.65±2.20-1.62±1.50) diabetics compared with the related control groups (p=0.01), (p=0.02).

Conclusion: Type I, II diabetic patients revealed lower salivary flow rate and higher xerostomia compared with healthy controls. The salivary flow rate and xerostomia had inverse correlation.

 

References

Glick M. Burket's Oral Medicine, 12th ed: PMPH-USA; 567-83.

American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2011; 34

Suppl 1: S62-9. doi: 10.2337/dc11-S062. PMID: 21193628, PMCID: PMC3006051.

López-Pintor RM, Casañas E, González-Serrano J, Serrano J, Ramírez L, de Arriba L, et al. Xerostomia,

hyposalivation, and salivary flow in diabetes patients. Journal of Diabetes Research. 2016; 2016: 1-16. doi:

1155/2016/4372852.

Kuzuya T, Nakagawa S, Satoh J, Kanazawa Y, Iwamoto Y, Kobayashi M, et al. Report of the Committee

on the classification and diagnostic criteria of diabetes mellitus. Diabetes Res Clin Pract. 2002; 55(1): 65- 85. PMID: 11755481.

Manfredi M, McCullough MJ, Vescovi P, Al-Kaarawi ZM, Porter SR. Update on diabetes mellitus and

related oral diseases. Oral Dis. 2004; 10(4): 187-200. doi: 10.1111/j.1601-0825.2004.01019.x. PMID:

Malicka B, Kaczmarek U, Skośkiewicz-Malinowska K. Prevalence of xerostomia and the salivary flow rate

in diabetic patients. Adv Clin Exp Med. 2014; 23(2): 225-33. PMID: 24913113.

Chavez EM, Taylor GW, Borrell LN, Ship JA. Salivary function and glycemic control in older persons

with diabetes. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000; 89(3): 305-11. PMID: 10710454.

Chávez EM, Borrell LN, Taylor GW, Ship JA. A longitudinal analysis of salivary flow in control subjects

and older adults with type 2 diabetes. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 91(2):

-73. doi: 10.1067/moe.2001.112054. PMID: 11174593.

Lin CC, Sun SS, Kao A, Lee CC. Impaired salivary function in patients with noninsulin-dependent diabetes

mellitus with xerostomia. J Diabetes Complications. 2002; 16(2): 176-9. PMID: 12039402.

Fox PC, van der Ven PF, Sonies BC, Weiffenbach JM, Baum BJ. Xerostomia: evaluation of a symptom

with increasing significance. J Am Dent Assoc. 1985; 110(4): 519-25. PMID: 3858368.

Adler AI, Stevens RJ, Manley SE, Bilous RW, Cull CA, Holman RR. Development and progression of

nephropathy in type 2 diabetes: the United Kingdom Prospective Diabetes Study (UKPDS 64). Kidney Int.

; 63(1): 225-32. doi: 10.1046/j.1523-1755.2003.00712.x. PMID: 12472787.

Navazesh M. Methods for collecting saliva. Ann N Y Acad Sci. 1993; 694: 72-7. doi: 10.1111/j.1749- 6632.1993.tb18343.x. PMID: 8215087.

Panchbhai AS, Degwekar SS, Bhowte RR. Estimation of salivary glucose, salivary amylase, salivary total

protein and salivary flow rate in diabetics in India. J Oral Sci. 2010; 52(3): 359-68. doi:

2334/josnusd.52.359. PMID: 20881327.

Bakianian Vaziri P, Vahedi M, Mortazavi H, Abdollahzadeh Sh, Hajilooi M. Evaluation of salivary

glucose, IgA and flow rate in diabetic patients: a case-control study. J Dent (Tehran). 2010; 7(1): 13-8.

PMID: 21998770, PMCID: PMC3184719.

Karjalainen KM, Knuuttila ML, Käär ML. Relationship between caries and level of metabolic balance in

children and adolescents with insulin-dependent diabetes mellitus. Caries Res. 1997; 31(1): 13-8. PMID:

Carda C, Mosquera-Lloreda N, Salom L, Gomez de Feraris ME, Peydro A. Structural and functional

salivary disorders in type 2 diabetic patients. Med Oral Patol Oral Cir Bucal. 2006; 11(4): 309-14. PMID:

Little JW, Falace DA, Miller CS, Rhodus NL. Dental Management of the Medically Compromised

Patients. 8th. St. Louis; 2013: 219-40.

Moore PA, Guggenheimer J, Etzel KR, Weyant RJ, Orchard T. Type 1 diabetes mellitus, xerostomia and

salivary flow rates. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001; 92(3): 281-91. doi:

1067/moe.2001.117815. PMID: 11552145.

Ben-Aryeh H, Serouya R, Kanter Y, Szargel R, Laufer D. Oral health and salivary composition in diabetic

patients. J Diabetes Complications. 1993; 7(1): 57-62. PMID: 8481552.

Yavuzyilmaz E, Yumak Ö, Akdoǧanli T, Yamalik N, Özer N, Ersoy F, et al. The alterations of whole saliva

constituents in patients with diabetes mellitus. Aust Dent J. 1996; 41(3): 193-7. doi: 10.1111/j.1834- 7819.1996.tb04855.x. PMID: 8768645.

Expert Committee on the Diagnosis and Classification of Diabetes Mellitus. Report of the expert committee

on the diagnosis and classification of diabetes mellitus. Diabetes Care. 2003; 26 Suppl 1: S5-20. PMID:

Mandel ID. The diagnostic uses of saliva. J Oral Pathol Med. 1990; 19(3): 119-25. doi: 10.1111/j.1600- 0714.1990.tb00809.x. PMID: 2187975.

Newrick P, Bowman C, Green D, O’Brien I, Porter S, Scully C, et al. Parotid salivary secretion in diabetic

autonomic neuropathy. Journal of Diabetic Complications. 1991; 5(1): 35-7. doi: 10.1016/0891- 6632(91)90008-D.

Published

2022-02-12