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DOI: 10.1055/s-0042-1755553
Oral Manifestations: A Reliable Indicator for Undiagnosed Diabetes Mellitus Patients
Funding None.
Abstract
Objectives This article identifies undiagnosed DM (UDM) cases in the Pakistani population by perceiving the signs and symptoms of DM and associating them with oral manifestations.
Material and Methods In this cross-sectional study, patients showing at least three or more classical or warning signs like polydipsia, polyuria, polyphagia, and general weakness were considered UDM cases. Detailed oral examination for gingivitis, periodontitis, halitosis, xerostomia, and tongue manifestations was done followed by the hemoglobin A1c (HbA1c) analysis.
Results Out of 5,878 patients, 214 UDM cases were identified, where 31.8% and 39.7% of the patients were diagnosed as prediabetics and diabetics, respectively, based on HbA1c analysis. Prevalence of gingivitis (97.6%), fissured tongue (91.8%), generalized periodontitis (85.9%), thick saliva (87.1%), xerostomia (84.7%), burning mouth syndrome (63.5%), yellow discoloration of tongue (57.6%), and ecchymosis/ulcers (43.5%) were more in diabetics as compared to prediabetic patients and normal population.
Conclusion The oral manifestations can be crucial for identifying UDM cases. Dentists can play a pivotal role by taking detailed history and thorough oral examination. If three or more symptoms as concluded above are present, an HbA1c analysis should be conducted to prevent preop and postop complications associated with DM.
Publikationsverlauf
Artikel online veröffentlicht:
11. Oktober 2022
© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)
Thieme Medical and Scientific Publishers Pvt. Ltd.
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References
- 1 Saeedi P, Petersohn I, Salpea P. et al; IDF Diabetes Atlas Committee. Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9th edition. Diabetes Res Clin Pract 2019; 157: 107843
- 2 Ali Hassan S, Pratyusha F. Diabetes and oral diseases- a review. IP J Nutr Metab Heal Sci. 2020; 3 (01) 6-9
- 3 Al-Maskari AY, Al-Maskari MY, Al-Sudairy S. Oral manifestations and complications of diabetes mellitus: a review. Sultan Qaboos Univ Med J 2011; 11 (02) 179-186
- 4 Ramachandran A. Know the signs and symptoms of diabetes. Indian J Med Res 2014; 140 (05) 579-581
- 5 Akhtar S, Nasir JA, Abbas T, Sarwar A. Diabetes in Pakistan: a systematic review and meta-analysis. Pak J Med Sci 2019; 35 (04) 1173-1178
- 6 Ijaz M, Ali I, Hussain A. Diabetes mellitus in Pakistan: the past, present, and future. Int J Diabetes Dev Ctries 2020; 40 (01) 153-154
- 7 Aamir AH, Ul-Haq Z, Mahar SA. et al. Diabetes Prevalence Survey of Pakistan (DPS-PAK): prevalence of type 2 diabetes mellitus and prediabetes using HbA1c: a population-based survey from Pakistan. BMJ Open 2019; 9 (02) e025300
- 8 Genco RJ, Borgnakke WS. Diabetes as a potential risk for periodontitis: association studies. Periodontol 2000 2020; 83 (01) 40-45
- 9 Centers for Disease Control and Prevention. . “National Diabetes Statistics Report, 2020.” 2020. https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf . Accessed February 3, 2022
- 10 Heji ES, Bukhari AA, Bahammam MA, Homeida LA, Aboalshamat KT, Aldahlawi SA. Periodontal Disease as a predictor of undiagnosed diabetes or prediabetes in dental patients. Eur J Dent 2021; 15 (02) 216-221
- 11 Stumvoll M, Goldstein BJ, van Haeften TW. Type 2 diabetes: principles of pathogenesis and therapy. Lancet 2005; 365 (9467): 1333-1346
- 12 Indurkar MS, Maurya AS, Indurkar S. Oral manifestations of diabetes. Clin Diabetes 2016; 34 (01) 54-57
- 13 Moosa Y, Shahzad M, Shaikh AA, Matloob SA. Khalid M. Influence of diabetes mellitus on oral health. Pak Oral Dent J 2018; 38 (01) 67-70
- 14 Grigoriadis A, Koutounidou S, Räisänen I, Arsenakis M, Sakellari D. Interaction between TCF7L2 rs7903146 genotype, HbA1c levels, and the periodontal status of dental patients. Eur J Dent 2021; 15 (03) 495-501
- 15 Lin X, Xu Y, Pan X. et al. Global, regional, and national burden and trend of diabetes in 195 countries and territories: an analysis from 1990 to 2025. Sci Rep 2020; 10 (01) 14790
- 16 Mehmood K, Junaid N. Prevalence of undiagnosed type 2 diabetes mellitus in Pakistan: results of screen-diabetes disease registry. J Pak Med Assoc 2018; 68 (08) 1171-1178
- 17 Hussain A, Ali I. Diabetes mellitus in Pakistan: a major public health concern. Arch Pharm Pract (Mumbai) 2016; 7 (01) 30-33
- 18 Gazal G. Management of an emergency tooth extraction in diabetic patients on the dental chair. Saudi Dent J 2020; 32 (01) 1-6
- 19 Miller A, Ouanounou A. Diagnosis, management, and dental considerations for the diabetic patient. J Can Dent Assoc 2020; 86: k8
- 20 Hsu PC, Wu HK, Huang YC. et al. The tongue features associated with type 2 diabetes mellitus. Medicine (Baltimore) 2019; 98 (19) e15567
- 21 Tonetti MS, Greenwell H, Kornman KS. Staging and grading of periodontitis: framework and proposal of a new classification and case definition. J Periodontol 2018; 89 (Suppl. 01) S159-S172
- 22 Sherwani SI, Khan HA, Ekhzaimy A, Masood A, Sakharkar MK. Significance of HbA1c test in diagnosis and prognosis of diabetic patients. Biomark Insights 2016; 11: 95-104
- 23 American Diabetes Association. Glycemic targets: standards of medical care in diabetes—2018. In: Diabetes Care. Vol. 41. American Diabetes Association; 2018. :S55–S64
- 24 Gonzalez A, Deng Y, Lane AN. et al. Impact of mismatches in HbA1c vs glucose values on the diagnostic classification of diabetes and prediabetes. Diabet Med 2020; 37 (04) 689-696
- 25 Meo SA, Zia I, Bukhari IA, Arain SA. Type 2 diabetes mellitus in Pakistan: current prevalence and future forecast. J Pak Med Assoc 2016; 66 (12) 1637-1642
- 26 Kunsongkeit P, Okuma N, Rassameemasmaung S, Chaivanit P. Effect of vitamin C as an adjunct in nonsurgical periodontal therapy in uncontrolled type 2 diabetes mellitus patients. Eur J Dent 2019; 13 (03) 444-449
- 27 Vernillo AT. Dental considerations for the treatment of patients with diabetes mellitus. J Am Dent Assoc 2003; 134 (Spec No): 24S-33S
- 28 Seethalakshmi C, Reddy RC, Asifa N, Prabhu S. Correlation of salivary pH, incidence of dental caries and periodontal status in diabetes mellitus patients: a cross-sectional study. J Clin Diagn Res 2016; 10 (03) ZC12-ZC14
- 29 Berniyanti T, Wening GRS, Palupi R, Setyowati D, Putri CR. Low levels of tumor necrosis factor-? will prevent periodontitis exacerbation in type 2 diabetes mellitus. Eur J Dent 2022; 16 (02) 443-448
- 30 Vincent RR, Appukuttan D, Victor DJ, Balasundaram A. Oxidative stress in chronic periodontitis patients with type II diabetes mellitus. Eur J Dent 2018; 12 (02) 225-231
- 31 Choi J-S. Association between self-assessed gingival bleeding and halitosis, and glycated hemoglobin levels in patients with diabetes. J Korean Soc Dent Hyg 2020; 20 (01) 19-27
- 32 Al-Zahrani MS, Zawawi KH, Austah ON, Al-Ghamdi HS. Self reported halitosis in relation to glycated hemoglobin level in diabetic patients. Open Dent J 2011; 5 (01) 154-157
- 33 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 (02) 166-173
- 34 Cicmil S, Mladenović I, Krunić J, Ivanović D, Stojanović N. Oral alterations in diabetes mellitus. Balk J Dent Med 2018; 22 (01) 7-14
- 35 Gurvits GE, Tan A. Burning mouth syndrome. World J Gastroenterol 2013; 19 (05) 665-672
- 36 Maltsman-Tseikhin A, Moricca P, Niv D. Burning mouth syndrome: will better understanding yield better management?. Pain Pract 2007; 7 (02) 151-162
- 37 Hamrah MH, Baghalian A, Ghadimi S, et al. The prevalence and correlates of fissured tongue among outpatients in a regional area of Afghanistan: a cross-sectional study. Clin Cosmet Investig Dent 2021; 13: 68-70
- 38 Tomooka K, Saito I, Furukawa S. et al. Yellow tongue coating is associated with diabetes mellitus among Japanese non-smoking men and women: the Toon Health Study. J Epidemiol 2018; 28 (06) 287-291
- 39 El Toum S, Cassia A, Bouchi N, Kassab I. Prevalence and distribution of oral mucosal lesions by sex and age categories: a retrospective study of patients attending Lebanese School of Dentistry. Int J Dent 2018; 2018: 4030134