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Rondanelli M, Barrile GC, Cavioni A, Donati P, Genovese E, Mansueto F, Mazzola G, Patelli Z, Pirola M, Razza C, Russano S, Sivieri C, Tartara A, Valentini EM, Perna S. A Narrative Review on Strategies for the Reversion of Prediabetes to Normoglycemia: Food Pyramid, Physical Activity, and Self-Monitoring Innovative Glucose Devices. Nutrients 2023; 15:4943. [PMID: 38068801 PMCID: PMC10707766 DOI: 10.3390/nu15234943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 11/16/2023] [Accepted: 11/21/2023] [Indexed: 12/18/2023] Open
Abstract
In 2019, "Nutrition Therapy for Adults with Diabetes or Prediabetes: A Consensus Report" was published. This consensus report, however, did not provide an easy way to illustrate to subjects with prediabetes (SwPs) how to follow a correct dietary approach. The purpose of this review is to evaluate current evidence on optimum dietary treatment of SwPs and to provide a food pyramid for this population. The pyramid built shows that everyday consumption should consist of: whole-grain bread or potatoes eaten with their skins (for fiber and magnesium) and low glycemic index carbohydrates (GI < 55%) (three portions); fruit and vegetables (5 portions), in particular, green leafy vegetables (for fiber, magnesium, and polyphenols); EVO oil (almost 8 g); nuts (30 g, in particular, pistachios and almonds); three portions of dairy products (milk/yogurt: 300-400 g/day); mineral water (almost 1, 5 L/day for calcium intake); one glass of wine (125 mL); and three cups of coffee. Weekly portions should include fish (four portions), white meat (two portions), protein plant-based food (four portions), eggs (egg portions), and red/processed meats (once/week). At the top of the pyramid, there are two pennants: a green one means that SwPs need some personalized supplementation (if daily requirements cannot be satisfied through diet, vitamin D, omega-3, and vitamin B supplements), and a red one means there are some foods and factors that are banned (simple sugar, refined carbohydrates, and a sedentary lifestyle). Three to four times a week of aerobic and resistance exercises must be performed for 30-40 min. Finally, self-monitoring innovative salivary glucose devices could contribute to the reversion of prediabetes to normoglycemia.
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Affiliation(s)
- Mariangela Rondanelli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Gaetan Claude Barrile
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Alessandro Cavioni
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Paolo Donati
- AICUBE srl, 20090 Trezzano sul Naviglio, Italy; (P.D.); (S.R.)
| | - Elisa Genovese
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Francesca Mansueto
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Giuseppe Mazzola
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Zaira Patelli
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Martina Pirola
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Claudia Razza
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Stefano Russano
- AICUBE srl, 20090 Trezzano sul Naviglio, Italy; (P.D.); (S.R.)
| | - Claudia Sivieri
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Alice Tartara
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Eugenio Marzio Valentini
- Department of Public Health, Experimental and Forensic Medicine, University of Pavia, 27100 Pavia, Italy; (G.C.B.); (A.C.); (E.G.); (F.M.); (G.M.); (Z.P.); (M.P.); (C.R.); (C.S.); (A.T.); (E.M.V.)
| | - Simone Perna
- Department of Food, Environmental and Nutritional Sciences, Division of Human Nutrition, University of Milan, 20133 Milan, Italy;
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Bargues-Navarro G, Ibáñez-del Valle V, El Mlili N, Cauli O. Salivary Biomarkers Associated with Psychological Alterations in Patients with Diabetes: A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2022; 58:medicina58081091. [PMID: 36013558 PMCID: PMC9416232 DOI: 10.3390/medicina58081091] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Revised: 07/26/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022]
Abstract
The care of individuals with diabetes needs a holistic perspective, taking into account both the physical disease and the mental health problems that may be associated. Different studies show a higher prevalence of depression or anxiety issues in diabetes patients than in the general population, which is why diabetes can be considered one of the chronic diseases in which psychological care is crucial to maintain quality of life. The objective of this review is to examine the published articles that relate the bidirectional associations between objective and subjective measures of anxiety, depressive symptomatology, stress, sleep quality, and salivary biomarkers in patients with diabetes. For this, a search was carried out in the electronic databases PubMed, Cochrane, and SCOPUS using the keywords "diabetes", "saliva", "sleep", "anxiety", "depression", and "stress" for works published up until May 2022 and limited to the English and Spanish languages. The sample comprised 14 articles, 5 of which analysed the associations between depressive symptomatology and salivary biomarkers in people with diabetes. Among the salivary biomarkers most frequently used to evaluate psychological alterations in persons with diabetes are cortisol and melatonin. Thus, significant changes in the levels of these biomarkers were observed in most studies. Four out of five studies reported a statistically significant relationship between increased salivary cortisol in the evening/midnight or the cortisol awakening response and depressive symptoms. In contrast, lower cortisol levels upon waking in the morning were observed when there was no depression or anxiety. Regarding the association between salivary cortisol values and sleep quality in patients with diabetes, lower morning cortisol values related to prolonged nighttime sleep were common in the analysed studies. Low melatonin concentrations showed a negative correlation with sleep quality. As it is an easy-to-apply and non-invasive method, the measurement of salivary biomarkers can be very useful for predicting psychological alterations in patients with diabetes. Further scientific studies are required to determine the sensitivity of these biological substances acting as biomarkers for detecting sleep disorders and psychological alterations.
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Affiliation(s)
- Guillermo Bargues-Navarro
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, Avda Menéndez Pidal 19, 46010 Valencia, Spain
| | - Vanessa Ibáñez-del Valle
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, Avda Menéndez Pidal 19, 46010 Valencia, Spain
- Frailty and Cognitive Impairment Organized Group (FROG), University of Valencia, 46010 Valencia, Spain
- Chair of Active Ageing, University of Valencia, 4610 Valencia, Spain
| | - Nisrin El Mlili
- Higher Institute of Nursing Professions and Health Techniques (ISPITS), Tetouan 93000, Morocco
- Department of Biology and Health, Faculty of Sciences, University Abdelmalek Essâadi, Tetouan 93000, Morocco
| | - Omar Cauli
- Department of Nursing, Faculty of Nursing and Podiatry, University of Valencia, Avda Menéndez Pidal 19, 46010 Valencia, Spain
- Frailty and Cognitive Impairment Organized Group (FROG), University of Valencia, 46010 Valencia, Spain
- Chair of Active Ageing, University of Valencia, 4610 Valencia, Spain
- Correspondence:
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Lin D, Yang SW, Hsieh CL, Hsu KJ, Gong T, Wu Q, Qiu S, Feng S, Kong KV. Tandem Quantification of Multiple Carbohydrates in Saliva Using Surface-Enhanced Raman Spectroscopy. ACS Sens 2021; 6:1240-1247. [PMID: 33560111 DOI: 10.1021/acssensors.0c02533] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
The detection of carbohydrates in human body fluids is critical for disease diagnosis and healthy monitoring. Despite recent advances in glucose sensing, multiplex detection of different carbohydrates within a single assay that is capable of efficiently providing richer health information remains challenging. Herein, we report a versatile surface-enhanced Raman spectroscopy-based platform for the quantitative detection of monosaccharides (glucose, fructose, and galactose) in one test using a displace-and-trap mechanism. Moreover, due to the use of multiple optical interference-free (1800-2200 cm-1) signal-independent Raman probes, the detection range of this platform (0.125-7 mg/dL) perfectly covers physiological concentrations, enabling the quantitative detection of glucose and galactose in clinical human saliva samples. This work provides a noninvasive and high-efficiency potential tool for the screening of clinical diabetes and other carbohydrate-related diseases.
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Affiliation(s)
- Duo Lin
- Key Laboratory of OptoElectronic Science and Technology for Medicine, Ministry of Education, Fujian Provincial Key Laboratory for Photonics Technology, Digital Fujian Internet-of-Things Laboratory of Environment Monitoring, Fujian Normal University, Fuzhou 350007, China
| | - Shang-Wei Yang
- Department of Chemistry, National Taiwan University, Taipei 10617, Taiwan
| | - Chang-Lin Hsieh
- Department of Chemistry, National Taiwan University, Taipei 10617, Taiwan
| | - Keng-Jia Hsu
- Department of Chemistry, National Taiwan University, Taipei 10617, Taiwan
| | - Tianxun Gong
- State Key Laboratory of Electronic Thin Films and Integrated Devices, School of Electronic Science and Engineering (National Exemplary School of Microelectronics), University of Electronic Science and Technology of China, Chengdu 610054, China
| | - Qiong Wu
- Key Laboratory of OptoElectronic Science and Technology for Medicine, Ministry of Education, Fujian Provincial Key Laboratory for Photonics Technology, Digital Fujian Internet-of-Things Laboratory of Environment Monitoring, Fujian Normal University, Fuzhou 350007, China
| | - Sufang Qiu
- Department of Radiation Oncology, Fujian Provincial Key Laboratory of Translational Cancer Medicine, Fujian Medical University Cancer Hospital & Fujian Cancer Hospital, Fuzhou 350014, China
| | - Shangyuan Feng
- Key Laboratory of OptoElectronic Science and Technology for Medicine, Ministry of Education, Fujian Provincial Key Laboratory for Photonics Technology, Digital Fujian Internet-of-Things Laboratory of Environment Monitoring, Fujian Normal University, Fuzhou 350007, China
| | - Kien Voon Kong
- Department of Chemistry, National Taiwan University, Taipei 10617, Taiwan
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Pérez-Ros P, Navarro-Flores E, Julián-Rochina I, Martínez-Arnau FM, Cauli O. Changes in Salivary Amylase and Glucose in Diabetes: A Scoping Review. Diagnostics (Basel) 2021; 11:453. [PMID: 33800850 PMCID: PMC8001770 DOI: 10.3390/diagnostics11030453] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 02/11/2021] [Accepted: 03/03/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND AND OBJECTIVE Diabetes mellitus (DM) is a common long-term disease which can be related with salivary amylase levels. DM has recently been associated with salivary amylase diagnostics that could further impair diagnoses in the diabetic population, as well as being an interesting alternative to traditional methods of determine glucose levels. The main advantage of this method is related to the fact that it is a fast diagnostic method. The DM population experiences changes to their metabolism which affects their salivary parameters, making this an alternative procedure for diagnosis and follow-up of the illness due to the non-invasive nature of salivary analyzes. The objective of this review is to summarize the evidence regarding the changes in salivary amylase and glucose levels, and their relationship with blood markers of glycemic control used in clinical settings such as blood glucose and glycated hemoglobin. The differences in salivary amylase levels depending on the method of saliva collection under fasting or non-fasting conditions. The changes in salivary amylase depends on the type of diabetes, the type of insulin treatment or the quality of glycemic control. CONCLUSIONS Salivary amylase concentration is increased in diabetic patients in most of the studies and salivary glucose concentration in all studies in both fasting and non-fasting (post-prandial) conditions. Salivary amylase and glucose concentration represent potential non-invasive biomarkers to evaluate glycemic control and clinical management of diabetic patients, although it is necessary to evaluate the influence of potential modulating factors such as age, duration diseases, sex and the effects of pharmacological treatments in these outcomes which remained to be elucidated.
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Affiliation(s)
- Pilar Pérez-Ros
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, 46010 Valencia, Spain; (P.P.-R.); (E.N.-F.); (I.J.-R.); (F.M.M.-A.)
- Nursing Department, University of Valencia, 46010 Valencia, Spain
| | - Emmanuel Navarro-Flores
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, 46010 Valencia, Spain; (P.P.-R.); (E.N.-F.); (I.J.-R.); (F.M.M.-A.)
- Nursing Department, University of Valencia, 46010 Valencia, Spain
| | - Ivan Julián-Rochina
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, 46010 Valencia, Spain; (P.P.-R.); (E.N.-F.); (I.J.-R.); (F.M.M.-A.)
- Nursing Department, University of Valencia, 46010 Valencia, Spain
| | - Francisco Miguel Martínez-Arnau
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, 46010 Valencia, Spain; (P.P.-R.); (E.N.-F.); (I.J.-R.); (F.M.M.-A.)
- Department of Physiotherapy, University of Valencia, 46010 Valencia, Spain
| | - Omar Cauli
- Frailty and Cognitive Impairment Research Group (FROG), University of Valencia, 46010 Valencia, Spain; (P.P.-R.); (E.N.-F.); (I.J.-R.); (F.M.M.-A.)
- Nursing Department, University of Valencia, 46010 Valencia, Spain
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Dornelas Figueira LM, Ricomini Filho AP, da Silva WJ, Del BeL Cury AA, Ruiz KGS. Glucose effect on Candida albicans biofilm during tissue invasion. Arch Oral Biol 2020; 117:104728. [PMID: 32585445 DOI: 10.1016/j.archoralbio.2020.104728] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 03/18/2020] [Accepted: 04/07/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate, in vitro, the effect of two glucose concentrations (0.1 mM and 1.0 mM, simulating glucose concentration in saliva of healthy and diabetic individuals) on Candida albicans biofilm grown on epithelial monolayer. MATERIAL AND METHODS C. albicans was inoculated on epithelial monolayers supplemented with 0.1 mM, 1.0 mM or no glucose. Control groups without C. albicans were also evaluated. Tissue response was assessed through the production of Interleukin-1α, Interleukin-8, Interleukin-6, Interleukin-10 and tumor necrosis factor-α. The complex of monolayer and biofilms were evaluated by quantitative reverse transcription polymerase chain reaction for expression of E-cadherin (CDH1), Caspase-3 (CASP3), β-defensin-1 (DEFB-1) and β-defensin-3 (DEFB-3). The biofilm architecture was visualized by confocal laser scanning microscopy. RESULTS The production of Interleukin-1α and Interleukin-8 were increased in the presence of C. albicans (p < 0.05). Glucose did not interfere in the release of any cytokine evaluated. C. albicans downregulated transcripts for CDH1 (p < 0.05). Glucose did not induce a significant change in CDH1, CASP3, DEFB-1 and DEFB-3 messenger RNA expression. The biofilms were more structured in the presence of glucose, but no difference in the diffusion of hyphae through the epithelial cells were observed. CONCLUSIONS The data suggest that glucose concentration does not affect the behavior of C. albicans during tissue invasion and other mechanisms must be related to the greater susceptibility of diabetic individuals to candidiasis.
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Affiliation(s)
- Louise Morais Dornelas Figueira
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | | | - Wander José da Silva
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Altair Antoninha Del BeL Cury
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
| | - Karina Gonzales Silvério Ruiz
- Department of Prosthodontics and Periodontology, Piracicaba Dental School, University of Campinas, Piracicaba, São Paulo, Brazil
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Saliva diagnostic utility in patients with type 2 diabetes: Future standard method. J Med Biochem 2020; 39:140-148. [PMID: 33033445 DOI: 10.2478/jomb-2019-0019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 04/03/2019] [Indexed: 11/20/2022] Open
Abstract
Background The purpose of the present study was to assess saliva reliability in diagnosis and monitoring type 2 diabetes instead of blood. Methods Blood and unstimulated whole saliva were collected from 300 type 2 diabetic subjects and 300 healthy controls in fasting. Then, the salivary flow rate was calculated. All parameters including glucose, urea, amylase, total protein, albumin, C-reactive protein (CRP), immunoglobulin A (IgA), potassium, calcium and chloride were assessed in the supernatant, using an autoanalyzer. Oral exam was conducted by a single examiner on full mouth excluding third molars. Statistical analysis was performed by the SPSS 20.0 version. Results Saliva screening showed that glucose, urea, amylase, total protein, potassium, calcium and chloride were significantly higher in patients compared to controls (p < 0.05). Whereas, the IgA level and salivary flow rate were significantly reduced in patients (p < 0.05). No significant difference was found in albumin and CRP levels (p > 0.05). There was a significant positive correlation between salivary and plasma glucose levels (r = 0.887, and r = 0.900, p < 0.001), as well as, salivary and blood urea (r = 0.586, and r = 0.688, p < 0.001) in patients and controls, respectively. Conclusions From this study, saliva could be suggested as a useful diagnostic tool for type 2 diabetes.
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Coelho AS, Amaro IF, Caramelo F, Paula A, Marto CM, Ferreira MM, Botelho MF, Carrilho EV. Dental caries, diabetes mellitus, metabolic control and diabetes duration: A systematic review and meta-analysis. J ESTHET RESTOR DENT 2020; 32:291-309. [PMID: 31912978 DOI: 10.1111/jerd.12562] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 11/04/2019] [Accepted: 12/17/2019] [Indexed: 12/16/2022]
Abstract
OBJECTIVE To analyze articles aimed at evaluating the association between diabetes, metabolic control, diabetes duration, and dental caries. OVERVIEW A systematic search in PubMed, Cochrane Library, Embase, and Web of Science was conducted to retrieve papers in English, Portuguese, and Spanish, up to April 2019. The research strategy was constructed considering the "PECO" strategy. Only quantitative observational studies were analyzed. The risk of bias was assessed using the Newcastle-Ottawa Quality Assessment Scale. The meta-analyses were performed based on random-effects models using the statistical platform R. A total of 69 articles was included in the systematic review and 40 in the meta-analysis. Type 1 diabetics have a significantly higher DMFT compared to controls. No significant differences were found between type 2 diabetics and controls and between well-controlled and poorly controlled diabetics. Concerning diabetes duration, all authors failed to find differences between groups. CONCLUSION Although there is still a need for longitudinal studies, the meta-analysis proved that type 1 diabetics have a high dental caries risk. CLINICAL SIGNIFICANCE It is necessary to be aware of all risk factors for dental caries that may be associated with these patients, making it possible to include them into an individualized prevention program.
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Affiliation(s)
- Ana Sofia Coelho
- Faculty of Medicine, Institute of Integrated Clinical Practice, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, CIMAGO-Center of Investigation on Environment, Genetics and Oncobiology, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal
| | - Inês Flores Amaro
- Faculty of Medicine, Institute of Integrated Clinical Practice, University of Coimbra, Coimbra, Portugal
| | - Francisco Caramelo
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, CIMAGO-Center of Investigation on Environment, Genetics and Oncobiology, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, Laboratory of Biostatistics and Medical Informatics, University of Coimbra, Coimbra, Portugal
| | - Anabela Paula
- Faculty of Medicine, Institute of Integrated Clinical Practice, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, CIMAGO-Center of Investigation on Environment, Genetics and Oncobiology, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal
| | - Carlos Miguel Marto
- Faculty of Medicine, Institute of Integrated Clinical Practice, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, CIMAGO-Center of Investigation on Environment, Genetics and Oncobiology, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, Experimental Pathology Institute, University of Coimbra, Coimbra, Portugal
| | - Manuel Marques Ferreira
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, CIMAGO-Center of Investigation on Environment, Genetics and Oncobiology, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, Institute of Endodontics, University of Coimbra, Coimbra, Portugal
| | - Maria Filomena Botelho
- Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, CIMAGO-Center of Investigation on Environment, Genetics and Oncobiology, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal
| | - Eunice Virgínia Carrilho
- Faculty of Medicine, Institute of Integrated Clinical Practice, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, Coimbra Institute for Clinical and Biomedical Research (iCBR), University of Coimbra, Coimbra, Portugal.,Center for Innovative Biomedicine and Biotechnology, University of Coimbra, Coimbra, Portugal.,Faculty of Medicine, CIMAGO-Center of Investigation on Environment, Genetics and Oncobiology, University of Coimbra, Coimbra, Portugal.,CNC.IBILI, University of Coimbra, Coimbra, Portugal
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Tiongco REG, Arceo ES, Rivera NS, Flake CCD, Policarpio AR. Estimation of salivary glucose, amylase, calcium, and phosphorus among non-diabetics and diabetics: Potential identification of non-invasive diagnostic markers. Diabetes Metab Syndr 2019; 13:2601-2605. [PMID: 31405682 DOI: 10.1016/j.dsx.2019.07.037] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 07/12/2019] [Indexed: 12/11/2022]
Abstract
AIMS Diabetes Mellitus (DM) continues to burden millions of people worldwide. Early detection and effective diagnosis of DM are essential key strategies to reduce the impeding incidence of the disease and its complications. Thus, this study determined the potential utility of salivary glucose, amylase, calcium, and phosphorus as non-invasive diagnostic markers of DM. MATERIALS AND METHODS A total of 80 participants were recruited and divided into two groups (non-diabetics and diabetics). Fasting blood samples and unstimulated saliva samples were collected and tested for glucose, amylase, calcium, and phosphorus. RESULTS Mann-Whitney U test shows that salivary glucose and salivary amylase were significantly higher among diabetics than non-diabetics. In addition to this, the receiver operations characteristics (ROC) curve showed that salivary glucose (AUC = 0.811, p < 0.001) and amylase (AUC = 0.649, p = 0.03) has significant association with DM. CONCLUSION Overall, only salivary glucose and amylase showed good potential in discriminating patients with diabetes from those without.
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Affiliation(s)
- Raphael Enrique G Tiongco
- Department of Medical Technology, College of Allied Medical Professions, Angeles University Foundation, Angeles City, Philippines.
| | - Engracia S Arceo
- Department of Medical Technology, College of Allied Medical Professions, Angeles University Foundation, Angeles City, Philippines
| | - Nicole S Rivera
- Department of Medical Technology, College of Allied Medical Professions, Angeles University Foundation, Angeles City, Philippines
| | - Chastene Christopher D Flake
- Department of Medical Technology, College of Allied Medical Professions, Angeles University Foundation, Angeles City, Philippines
| | - Archie R Policarpio
- Department of Medical Technology, College of Allied Medical Professions, Angeles University Foundation, Angeles City, Philippines
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Fares S, Said MSM, Ibrahim W, Amin TT, Saad NES. Accuracy of salivary glucose assessment in diagnosis of diabetes and prediabestes. Diabetes Metab Syndr 2019; 13:1543-1547. [PMID: 31336519 DOI: 10.1016/j.dsx.2019.03.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 03/05/2019] [Indexed: 10/27/2022]
Abstract
AIMS to assess salivary glucose correlation with blood glucose and its accuracy in diagnosis of diabetes and prediabetes. MATERIALS AND METHODS A comparative study including 204 adults in 3 groups (104 type 2 diabetics, 50 prediabetics, 50 non-diabetic controls) aging 18-65 years. The participants were interviewed about their socio-demographic, comorbidities, & drug treatment using a predesigned questionnaire. Salivary & blood samples were collected and analyzed. RESULTS Mean salivary glucose was observed to be 23.40 ± 12.755 mg/dl in control group, 42.68 ± 20.830 mg/dl in prediabetic group and 59.32 ± 19.147 mg/dl in diabetic group with significant difference between the 3 groups (P value < 0.001). Salivary glucose was significantly correlated to FBS with strong positive association (r = 0.67, P value < 0.001 in control group, r = 0.56, P value < 0.001in diabetic group and r = 0.36, P value 0.01 in pre-diabetic group). Salivary glucose could differentiate non-diabetics from diabetics (AUC: 0.928, P value < 0.001) with sensitivity (94.2%) and specificity (62%) & differentiate non-diabetics from prediabetics (AUC: 0.928, P value < 0.001) with sensitivity (94.2%) and specificity (62%). CONCLUSIONS Salivary glucose estimation can serve as valid and non-invasive test for screening and diagnosis of diabetes & prediabetes.
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Tiongco RE, Bituin A, Arceo E, Rivera N, Singian E. Salivary glucose as a non-invasive biomarker of type 2 diabetes mellitus. J Clin Exp Dent 2018; 10:e902-e907. [PMID: 30386523 PMCID: PMC6203925 DOI: 10.4317/jced.55009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2018] [Accepted: 08/14/2018] [Indexed: 12/20/2022] Open
Abstract
Background Every year, millions of people are diagnosed with Diabetes mellitus (DM) and the number of new and undiagnosed cases continue to rise. Diagnosis of diabetes is usually performed by blood glucose analysis after fasting for a certain period. However, this method uses an invasive technique that can cause discomfort and even trauma to some patients which could eventually lead to behavioral changes such as avoidance of healthcare and laboratory testing. Studies that explore the diagnostic value of salivary glucose are promising due to the non-invasiveness of the test procedures and its potential correlation with blood results. Material and Methods The study conducted aimed to determine if salivary glucose can be utilized as an alternative to blood glucose in the screening, diagnosis, and monitoring of type 2 diabetes mellitus (T2DM). A total of 75 participants were recruited and equally divided into 3 groups (normal fasting glucose, impaired fasting glucose, and provisional DM) based on their fasting blood glucose (FBG) level. Blood and unstimulated saliva were collected from each participant and were subjected to glucose analysis using the routine glucose oxidase-peroxidase method. Results Using Pearson's correlation and linear regression, a high degree and significant correlation was observed between blood and salivary glucose (r = 0.715, p<0.001). Further analysis showed that salivary glucose is 88.5% sensitive and 61.5% specific with a positive predictive value of 45.8%, and a negative predictive value of 97.1%. Conclusions Salivary glucose is comparable to blood glucose in diagnosing and monitoring T2DM and is considered more advantageous than blood due to its non-invasive nature. Key words:Saliva, glucose, non-invasive, diabetes.
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Affiliation(s)
- Raphael-Enrique Tiongco
- Department of Medical Technology, College of Allied Medical Professions, Angeles University Foundation, Angeles City, 2009, Philippines
| | - Aira Bituin
- Department of Medical Technology, College of Allied Medical Professions, Angeles University Foundation, Angeles City, 2009, Philippines
| | - Engracia Arceo
- Department of Medical Technology, College of Allied Medical Professions, Angeles University Foundation, Angeles City, 2009, Philippines
| | - Nicole Rivera
- Department of Medical Technology, College of Allied Medical Professions, Angeles University Foundation, Angeles City, 2009, Philippines
| | - Eloisa Singian
- Department of Medical Technology, College of Allied Medical Professions, Angeles University Foundation, Angeles City, 2009, Philippines
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Naked-Eye Detection of Glucose in Saliva with Bienzymatic Paper-Based Sensor. SENSORS 2018; 18:s18041071. [PMID: 29614003 PMCID: PMC5948659 DOI: 10.3390/s18041071] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 03/17/2018] [Accepted: 03/23/2018] [Indexed: 12/31/2022]
Abstract
The high incidence of Diabetes Mellitus in low-income regions has promoted the development of low-cost alternatives to replace blood-based procedures. In this work, we present a bienzymatic paper-based sensor suitable for the naked-eye detection of glucose in saliva samples. The sensor was obtained by a stamping procedure and modified with chitosan to improve the colorimetric readout. The bienzymatic reaction of GOx-HRP coupled with 2,4,6-tribromo-3-hydroxy benzoic acid was applied for the detection of glucose within a range from 0 to 180 mgdL−1 in buffer and artificial saliva solutions. The visual readout was perceived by the naked eye and registered with an office scanner to evaluate the analytical performance. The results showed a limit of detection of 0.37 mgdL−1 (S/N = 3) with an R.S.D. of 1.69% and a linear range from 1 to 22.5 mgdL−1 with an R2 of 0.99235. The analysis of human saliva samples was performed without pre-processing, achieving recoveries from 92 to 114%. The naked-eye detection was evaluated under two different light settings, showing average recoveries of 108.58 and 90.65% for standard and low illumination. The proposed device showed potential for easy-to-use, sensitive, low-cost, fast, and device-free detection of salivary glucose suitable for untrained personnel operation and limited facilities.
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Dominguez RB, Orozco MA, Chávez G, Márquez-Lucero A. The Evaluation of a Low-Cost Colorimeter for Glucose Detection in Salivary Samples. SENSORS 2017; 17:s17112495. [PMID: 29104212 PMCID: PMC5713636 DOI: 10.3390/s17112495] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Revised: 09/26/2017] [Accepted: 10/04/2017] [Indexed: 12/20/2022]
Abstract
Given the limited access to healthcare resources, low-income settings require the development of affordable technology. Here we present the design and evaluation of a low-cost colorimeter applied to the non-invasive monitoring of Diabetes Mellitus through the detection of glucose in salival fluid. Samples were processed by the glucose oxidase-peroxidase enzymatic system and analyzed with the development equipment. A light emission diode of 532.5 nm was used as an excitation source and a RGB module was used as a receptor. A calibration curve to quantify the concentration of salivary glucose (0 to 18 mg/dL) was carried out by relating the RGB components registered with glucose concentrations, achieving a limit of detection of 0.17 mg/dL with a CV of 5% (n = 3). Salivary samples of diabetic and healthy volunteers were processed with the equipment showing an average concentration of 1.5519 ± 0.4511 mg/dL for the first and 4.0479 ± 1.6103 mg/dL for the last, allowing a discrimination between both groups. Results were validated against a UV-Vis-NIR spectrophotometer with a correspondence of R2 of 0.98194 between both instruments. Results suggest the potential application of the developed device to the sensitive detection of relevant analytes with a low-cost, user-friendly, low-power and portable instrumentation.
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Affiliation(s)
| | - Miguel A Orozco
- Department of Engineering and Chemistry of Materials, CIMAV S.C., 31136 Chihuahua, Mexico.
| | - Giovanny Chávez
- Department of Engineering and Chemistry of Materials, CIMAV S.C., 31136 Chihuahua, Mexico.
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Stimulated and Unstimulated Saliva Glucose Levels in Children Suffer Insulin-Dependent Diabetes Mellitus. ACTA ACUST UNITED AC 2017. [DOI: 10.5812/amh.64373] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Gupta S, Nayak MT, Sunitha JD, Dawar G, Sinha N, Rallan NS. Correlation of salivary glucose level with blood glucose level in diabetes mellitus. J Oral Maxillofac Pathol 2017; 21:334-339. [PMID: 29391704 PMCID: PMC5763852 DOI: 10.4103/jomfp.jomfp_222_15] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Background Saliva is a unique fluid, which is important for normal functioning of the oral cavity. Diabetes mellitus (DM) is a disease of absolute or relative insulin deficiency characterized by insufficient secretion of insulin by pancreatic beta-cells. The diagnosis of diabetes through blood is difficult in children, older adults, debilitated and chronically ill patients, so diagnosis by analysis of saliva can be potentially valuable as collection of saliva is noninvasive, easier and technically insensitive, unlike blood. The aim of the study was to correlate blood glucose level (BGL) and salivary glucose level (SGL) in DM patients. Methodology A cross-sectional study was conducted in 120 patients, who were categorized as 40 controlled diabetics, 40 uncontrolled diabetics and 40 healthy, age- and sex-matched individuals constituted the controls. The blood and unstimulated saliva samples were collected from the patients at the different intervals for fasting, random and postprandial levels. These samples were then subjected for analysis of glucose in blood and saliva using glucose oxidase/peroxidase reagent in HITACHI 902(R) Automatic analyzer, and the results were recorded. Results The mean SGLs were higher in uncontrolled and controlled diabetic groups than in nondiabetic group. A highly statistically significant correlation was found between fasting saliva glucose and fasting blood glucose in all the groups. Conclusion With increase in BGL, increase in SGL was observed in patients with diabetes suggesting that SGL can be used for monitoring glycemic level in DM.
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Affiliation(s)
- Shreya Gupta
- Department of Oral Pathology and Microbiolgy, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Meghanand T Nayak
- Department of Oral Pathology and Microbiolgy, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - J D Sunitha
- Department of Oral Pathology and Microbiolgy, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Geetanshu Dawar
- Department of Oral Pathology and Microbiolgy, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Nidhi Sinha
- Department of Oral Pathology and Microbiolgy, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
| | - Neelakshi Singh Rallan
- Department of Oral Pathology and Microbiolgy, Teerthanker Mahaveer Dental College and Research Centre, Moradabad, Uttar Pradesh, India
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Abstract
BACKGROUND Self-management of blood glucose (BG) is considered a norm for diabetes control. However, this invasive process is uncomfortable for patients, especially when intensive measurements with frequent finger pricks are required. Saliva, an alternative body fluid that is easily accessible and contains trace amount of glucose can be potentially used for the noninvasive monitoring of diabetes. METHODS As a solution for real-time glucose measurements using saliva for diabetic care, we have developed an on-chip disposable glucose nano-biosensor through a layer-by-layer assembly process. In this work, a clinical study of 10 healthy subjects was conducted to determine the potential usefulness of salivary glucose (SG) sensors for glycemic control. RESULTS Findings revealed (1) the individual BG/SG ratio at fasting was consistent over an entire year when there was no significant change of personal health; (2) the individual SG levels tracked closely with BG levels after meals; (3) a time difference of 15-30 minutes exists between peak levels of BG and SG; (4) 2 hours after a meal, the BG/SG ratio returned to a similar value at fasting. CONCLUSIONS We propose to measure fasting and pre- and 2-hour postprandial SG levels for self-management of glycemic levels. As a result, this article is not intended to replace the common BG tests. With preliminary results, we believe SG itself could be used as means for reliable diabetes monitoring and a potential fluid for prognosis of future disease.
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Affiliation(s)
- Yunqing Du
- Interdisciplinary Engineering Program, College of Engineering, Northeastern University, Boston, MA, USA
| | - Wenjun Zhang
- Interdisciplinary Engineering Program, College of Engineering, Northeastern University, Boston, MA, USA
| | - Ming L Wang
- Interdisciplinary Engineering Program, College of Engineering, Northeastern University, Boston, MA, USA
- Civil and Environmental Engineering, and Bioengineering Department, Northeastern University, Boston, MA, USA
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