Study to Evaluate Gingival Crevicular Blood as a Screening Tool for Blood Glucose Concentration

Abstract

There is a high prevalence of type 2 diabetes mellitus (DM) in the UAE. Recent national guidelines advise screening for undiagnosed diabetes in all adults aged ≥ 30 years. This study assessed the feasibility of identifying undiagnosed diabetes and prediabetes using gingival crevicular blood in patients with periodontitis. Twenty healthy controls (Group I) and twenty known diabetics (Group II) were recruited from the Periodontics Department in a cross-sectional study of 40 adults with chronic periodontitis. Gingival crevicular blood and capillary finger blood glucose concentration obtained during routine periodontal examination were analyzed by an Accu–Chek® Performa self-monitoring device. Diurnal effects were controlled. The mean age for Group I was 39.5 years (9.8) and for Group II it was 45.5 (10.2) with no significant difference by age between the two groups. The mean duration of diabetes in Group II was 5.7 (3.2) years. Mean blood glucose concentration from gingiva and finger within each group were not significantly different. Mean finger blood glucose concentration in Group II was significantly higher at 172(47) mg/dL than for Group I, 115.1(17) mg/dL (t=5.03, p<0.001). Similarly, mean gingival blood glucose was significantly higher in Group II compared to Group I, 173.2 (47.7) mg/dL and 116.3 (16.7) mg/dL respectively (p<0.001). There was a very strong correlation between mean blood glucose from finger capillaries and gingiva (0.996; p<0.001) within each group irrespective of gender, age, periodontitis and duration of diabetes. The duration of diabetes was highly predictive for both gingival and finger blood glucose concentration (p<0.001). Within Group I, 5 of the 20 patients were identified as pre-diabetic with a blood glucose concentration above 140 mg/dL. Gingival crevicular blood glucose can be measured with the Accu-Chek® Performa safely and easily to screen for the diabetic status of patients with bleeding on probing.