Український стоматологічний альманах (Mar 2018)
ANALYSIS OF BIOPHYSICAL PROPERTIES OF ORAL FLUID IN PATIENTS WITH TYPE 1 DIABETES MELLITUS
Abstract
Diabetes is recognized by WHO as the world's modern problem. Hyperglycemia leads to lesions of various organs, the development of severe complications of the disease. On the background of diabetes mellitus various dental diseases start and rapidly progress, first of all, dental caries and periodontal disease. The oral fluid supports the homeostasis of the oral cavity, so the study of its changes is an important non-invasive, simple diagnostic method for assessing the probability of dental diseases. Purpose of the study: the study of biophysical parameters of oral fluid in patients with type 1 diabetes mellitus. Materials and methods of research. Clinical examination of 95 patients with type 1 diabetes mellitus aged 18 to 52 in a state of compensation, subcompensation and decompensation. The duration of the disease in these people ranged from 2 to 37 years. The main indicator of assessing the degree of compensation for diabetes is glycosylated hemoglobin (HbA1c,%). The determination of the biophysical parameters of the oral fluid was carried out after the collection of unstimulated mixed saliva in graduated tubes in the morning. The pH of the oral fluid was measured using a pH meter, the salivation rate was measured using the methods of T.L. Redinova and A. R. Pozdiev, as well as viscosity of the oral liquid was visually examined. Results of the research and their discussion. These studies showed changes in the index of oral pH in patients with type 1 diabetes, depending on the state of compensation of the disease. 15 people who had compensated type 1 diabetes mellitus had an oral pH of 6,82±0,18. In 11 patients in the subсompensation state of type 1 diabetes mellitus, the pH of the oral liquid was also within the normal range and equaled 6,73±0,30, but in 6 people, the oral pH shifted to the sour side and was 6,31±0,07. In the decompensation state of type 1 diabetes mellitus, significant deviations of this index from the norm were detected. In 39 people, the oral pH index shift to the acidic side was recorded, the average value of it was 6,10±0,12, and in the 24 people the pH of the oral liquid was 7,64±0,11, which corresponds to its deviation to the alkaline side (p <0,05). The correlation between the pH of the oral liquid and the glycosylated hemoglobin (HbA1c), and the correlation between the pH index of the oral liquid and the level of glucose in the capillary blood on an empty stomach, according to the state of compensation of diabetes mellitus, were confirmed. It was found that in patients with type 1 diabetes, the salivation rate depends on the duration of the disease and the level of glycemia. In 25 patients with a disease duration of up to 5 years, the salivation rate was 0,38±0,03 ml/min; in 32 patients with type 1 diabetes duration from 5 to 10 years, the salivation rate was 0,33±0,02 ml /min, and in 38 patients with disease duration from 10 to 37 years, the salivation rate was the lowest and equaled 0,27±0,04 ml/min (p<0,05). Correlation relations between salivation rate and glycated hemoglobin (HbA1c), glucose level in capillary blood on an empty stomach, as well as between salivation rate and oral pH were determined. According to the results of the visual assessment of the oral fluid viscosity, it was found that in 25 people it was normal, in other words clear and watery, 7 persons had increased viscosity, 39 had a high degree of viscosity, oral fluid, and in 24 people it was low. Conclusions. Consequently, the obtained results indicate the primary effect of type 1 diabetes compensation degree and the influence of the disease duration on the biophysical properties of the oral fluid, namely pH, viscosity and salivation rate.
