LETTER TO EDITOR
Year : 2016 | Volume
: 27 | Issue : 1 | Page : 108-
Salivary glucose estimation in Type 2 diabetes mellitus patients
Vagish Kumar L Shanbhag
Department of Oral Medicine and Radiology, Yenepoya Dental College and Hospital, Yenepoya Research Centre, Yenepoya University, Mangalore, Karnataka, India
Vagish Kumar L Shanbhag
Department of Oral Medicine and Radiology, Yenepoya Dental College and Hospital, Yenepoya Research Centre, Yenepoya University, Mangalore, Karnataka
|How to cite this article:|
Shanbhag VL. Salivary glucose estimation in Type 2 diabetes mellitus patients.Indian J Dent Res 2016;27:108-108
|How to cite this URL:|
Shanbhag VL. Salivary glucose estimation in Type 2 diabetes mellitus patients. Indian J Dent Res [serial online] 2016 [cited 2019 Nov 21 ];27:108-108
Available from: http://www.ijdr.in/text.asp?2016/27/1/108/179842
The article, "Evaluation of salivary glucose, amylase, and total protein in Type 2 diabetes mellitus patients" authored by Indira et al. was read critically.  In the study, random blood glucose was obtained. Whether both blood and salivary samples were obtained simultaneously or at different periods of time is not mentioned in the article. If the blood and salivary samples were obtained at different periods of time, then this might be one of the reasons that the authors have not obtained any correlation between blood and salivary glucose levels. Salivary sample collection is ideally recommended when the patient is in fasting state.  According to this article, saliva was obtained between 9 and 11 am after 2 h of the breakfast. However, time of blood collection is not mentioned. To validate whether saliva can be used for diagnosing or monitoring diabetes mellitus, the method of saliva and blood collection should be uniform and standardized.
It is advised to store saliva in ice-chilled graduated saliva collector since most of the time, it is practically impossible to process the saliva immediately after collection.  Storage in ice will prevent degradation of salivary molecules and bacterial overgrowth, the factors which have potential to cause error in salivary estimation. Also, should be standardized is the method and machines used in salivary glucose estimation. Ultraviolet spectrophotometry is the most sensitive method for glucose estimation. It can detect salivary glucose values as low as 0.2 mg/dl. 
In exclusion criteria, it is mentioned that those patients consuming medications are excluded from the study. However, it is not clear whether diabetes patients who consume antidiabetic medications were also excluded. For saliva to be considered a useful diagnostic utility in diabetics, samples should also be collected from patients who take antidiabetic medications. This helps in validating whether salivary glucose can be used to monitor diabetes status of the patients through frequent salivary sampling. Patients who consume antidiabetic medications are eligible to be enrolled in studies involving measurement of salivary glucose and should not be excluded.  It is a good practice to instruct the patient to wash his mouth with a tap or distilled water twice or thrice before collecting saliva. , Future studies should attempt collecting saliva and blood samples simultaneously from large sample sizes at different times of the day to validate whether salivary glucose levels truly reflect the blood glucose levels in diabetes patients.
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