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Estimation of Advanced Glycation End Products in Saliva of Diabetic Patients

AIMS AND OBJECTIVE: 
1. To estimate and compare salivary and blood glucose level in diabetic (controlled and 
uncontrolled) and non diabetic patients. 
2. To estimate and compare salivary and blood AGE level in diabetic (controlled and uncontrolled) and non diabetic patients. 
3. Assess the periodontal status of diabetic (controlled and uncontrolled) and non diabetic patients and its correlation to salivary glucose and salivary AGE levels. 
HYPOTHESIS: 
1. There is increase in salivary and serum AGE level in diabetic patients compared to non diabetic patients. 
2. Salivary AGE level is directly proportional to blood AGE level. 
3. Increase in salivary glucose and salivary AGE level is associated with poor periodontal 
status in diabetic patients 
STUDY SETTING: 
Diabetic patients attending (n = 50) the Department of Diabetology, Voluntary Health service (VHS), Chennai and non-diabetic controls (n = 25) attending the department of Oral and Maxillofacial Pathology, Ragas Dental College & Hospital were included in the study. Verbal consent was obtained from every individual participating in the study .The study was approved by Institutional Review Board. The patient were divided into three groups. 
GROUP 1: (n = 25) - 
Comprised of controlled diabetic patients of 40-60 years of age. Controlled diabetes was defined as those having random non-fasting plasma glucose values >120 mg/dl and < 200mg/dl (controlled diabetics). 
GROUP 2: (n = 25) - 
Comprised uncontrolled diabetic patients of 40-60 years of age. Uncontrolled diabetes was defined as those having random non fasting plasma glucose values >200mg/dl (uncontrolled diabetics). 
GROUP 3: (n = 25) - 
Comprised of non -diabetic patients whose age and sex were matched with Group I and Group II with random non fasting plasma glucose values <120mg/dl (nondiabetics). 
EXCLUSION CRITERIA: 
1. Patient with removable partial or complete dentures. 
2. Patients who had taken antibiotics or antifungal medication for any condition for a 
period of 15 days before the sample collection. 
3. Patients with immunocompromised condition other than Diabetes mellitus, 
4. Pregnant women, 
5. Patients who had the habit of tobacco/areca nut use. 
MATERIALS: 
1. Test tubes, 
2. Tourniquet, 
3. Sterile disposable syringes, 
4. Mouth mirror, 
5. Explorer, 
6. Light source, 
7. Eppendof tubes, 
8. Saliva spitting container, 
9. Ice flask, 
10. Cotton, 
11. Spirit, 
12. CPITN (Community Periodontal Index for Treatment Needs), 
13. EDTA (Ethylene diamine tetraacetic acid), 
14. Fluoride, 
15. NMR tubes. 
16. NMR tube holder, 
17. Acetone, 
18. Pipette. 
Data entry, database management and all statistical calculations were performed 
with the aid of the Statistical Package for the Social Sciences (SPSS, version 11.5) 
software. Descriptive statistics were calculated for all variables. Differences in means 
between more than two groups were assessed using the one way (ANOVA) and post hoc 
analysis using Tukey’s test. Relationships between variables were evaluated by Pearson’s 
correlation coefficient. Linear regression line was drawn to find the scatterness of the 
points between random blood glucose and HbA1C, random blood glucose and salivary 
glucose, random blood glucose and salivary AGE, salivary AGE and HbA1C, salivary 
glucose and salivary AGE levels, salivary glucose and periodontal status, salivary AGE 
and periodontal status. A p value of <0.05 was considered to be statistically significant. 
When the observed value of the correlation coefficient did not show statistical 
significance, the result was considered as a non – linear relationship.