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Effect of Diabetes Mellitus Type 2 on Salivary Glucose – A Systematic Review and Meta-Analysis of Observational Studies

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  • Paulo Mascarenhas
  • Bruno Fatela
  • Isabel Barahona

Abstract

Background: Early screening of type 2 diabetes mellitus (DM) is essential for improved prognosis and effective delay of clinical complications. However, testing for high glycemia often requires invasive and painful blood testing, limiting its large-scale applicability. We have combined new, unpublished data with published data comparing salivary glucose levels in type 2 DM patients and controls and/or looked at the correlation between salivary glucose and glycemia/HbA1c to systematically review the effectiveness of salivary glucose to estimate glycemia and HbA1c. We further discuss salivary glucose as a biomarker for large-scale screening of diabetes or developing type 2 DM. Methods and Findings: We conducted a meta-analysis of peer-reviewed published articles that reported data regarding mean salivary glucose levels and/or correlation between salivary glucose levels and glycemia or HbA1c for type 2 DM and non-diabetic individuals and combined them with our own unpublished results. Our global meta-analysis of standardized mean differences on salivary glucose levels shows an overall large positive effect of type 2 DM over salivary glucose (Hedge's g = 1.37). The global correlation coefficient (r) between salivary glucose and glycemia was large (r = 0.49), with subgroups ranging from medium (r = 0.30 in non-diabetics) to very large (r = 0.67 in diabetics). Meta-analysis of the global correlation between salivary glucose and HbA1c showed an overall association of medium strength (r = 0.37). Conclusions: Our systematic review reports an overall meaningful salivary glucose concentration increase in type 2 DM and a significant overall relationship between salivary glucose concentration and associated glycemia/HbA1c values, with the strength of the correlation increasing for higher glycemia/HbA1c values. These results support the potential of salivary glucose levels as a biomarker for type 2 DM, providing a less painful/invasive method for screening type 2 DM, as well as for monitoring blood glucose levels in large cohorts of DM patients.

Suggested Citation

  • Paulo Mascarenhas & Bruno Fatela & Isabel Barahona, 2014. "Effect of Diabetes Mellitus Type 2 on Salivary Glucose – A Systematic Review and Meta-Analysis of Observational Studies," PLOS ONE, Public Library of Science, vol. 9(7), pages 1-15, July.
    • Handle: RePEc:plo:pone00:0101706
    DOI: 10.1371/journal.pone.0101706
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    Cited by:

    1. Douglas C Caixeta & Emília M G Aguiar & Léia Cardoso-Sousa & Líris M D Coelho & Stephanie W Oliveira & Foued S Espindola & Leandro Raniero & Karla T B Crosara & Matthew J Baker & Walter L Siqueira & R, 2020. "Salivary molecular spectroscopy: A sustainable, rapid and non-invasive monitoring tool for diabetes mellitus during insulin treatment," PLOS ONE, Public Library of Science, vol. 15(3), pages 1-18, March.
    2. Kornwipa Rungrueang & Suraphong Yuma & Chanita Tantipoj & Siribang-on Piboonniyom Khovidhunkit & Pornpoj Fuangtharnthip & Thitima Thuramonwong & Muneedej Suwattipong & Sirirak Supa-amornkul, 2021. "Oral Bacterial Microbiomes in Association with Potential Prediabetes Using Different Criteria of Diagnosis," IJERPH, MDPI, vol. 18(14), pages 1-15, July.

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