Salivary Factors, Candidal Colonization and Strain Diversity in Type II Diabetics

Abstract

Introduction: Diabetes mellitus is one of the most common metabolic disorders of 21st century, occurring due to defect in insulin secretion or action resulting in chronic hyperglycemia. It is associated with altered salivary composition and function due to potential of insulin to alter metabolism in acinar cells. Diabetes, being an immunodeficient state is susceptible infections of which Candida is very frequent. Aim: To correlate salivary glucose, total protein and amylase levels, oral candidal carriage and strain diversity in type II diabetics. Materials and Methods: Salivary parameters, candidal carriage and strain diversity were assessed in 30 controlled and 30 uncontrolled type II diabetic individuals and 30 healthy controls. Glucose, total protein and amylase levels of unstimulated whole saliva were estimated by Glucose oxidase, dye binding and direct substrate kinase methods respectively; Candidal carriage and species identification by oral rinse and CHROMagar culture methods. Results: Uncontrolled diabetics showed significant increase of all salivary parameters and candidal carriage (p < 0.001) compared to other groups. Non Candida albicans species were isolated in higher frequency (78.88%) in uncontrolled diabetics, with C. tropicalis (47/90) dominating. Significant correlation existed between all the salivary parameters and candidal carriage from healthy to diabetic states. Conclusion: The consistent and significant increase of salivary parameters, candidal carriage and Non albicans Candida species in uncontrolled diabetics reflected the severity of the diabetic status implicating their diagnostic and prognostic merits. The correlation observed substantiated the role of salivary parameters in increasing candidal adherence.

Keywords

• candida species
• oral candidal carriage
• salivary glucose
• salivary total protein
• salivary amylase