Evaluation of 1, 5-anhydroglucitolas a salivary biomarker in Type 2 diabetes mellitus patients

Diabetes mellitus (DM) being one of the oldest diseases known to man was reported in Egyptian manuscript during 3000 years ago.[1] It is caused due to low levels of insulin hormone secreted by beta-cells of islet of Langerhans in the pancreas.[2] Insulin resistance at the level of insulin receptors, effector enzymes, or genes signal transduction system is responsible for these metabolic abnormalities occurring mainly in skeletal muscles, adipose tissue, and liver.[3] Insulin-dependent diabetes (Type 1) is mainly due to autoimmune destruction of pancreatic β-cells through T-cell-mediated inflammatory response (insulates) and humoral (B-cell) response. Non-insulin-dependent DM (Type 2) consists of insulin resistance and defects in the function of pancreatic β-cells resulting in increased demand for insulin, accounting for 85–90% of all cases.[4] DM accounts for 4.6 million deaths annually worldwide and seen more in lowand middle-income countries with 50% of cases remain undiagnosed.[5] India has the highest number of diabetic patients in the world. According to the International Diabetes Federation, incidence rate of diabetes in India is reported to increase 10-fold from 1.2% in 1971 to 12.1% in 2006 and further to 7.7% by 2030 posing enormous health problems and making India the diabetic capital of the world.[6] The screening tests for diabetes using serum collection following invasive techniques include hemoglobin A1C (HbA1C), fasting blood plasma, impaired glucose tolerance, and impaired glucose tolerance test.[7] Demand for rapid and non-invasive diagnostic tests has developed exponentially in the past decade, leading to widespread research on saliva as biological fluid for clinical diagnosis.[8] Saliva has several advantages compared to blood and urine such as easy collection of sample, economical for storing and transportation, and noninvasive method of collection decreases anxiety and discomfort in apprehensive patients. Consequently, saliva can be used as a non-invasive diagnostic tool for diabetic screening.[9] 1, 5-anhydroglucitol (1, 5-AG) is a small monosaccharide supplied from diet. It is sourced in high quantities from rice, soybeans bread, beef, and other plant sources and remains stable in the body due to balance between intestinal absorption, urinary Abstract Background: Diabetes mellitus (DM) being foremost clinical and public health problem accounts for 4.6 million deaths annually worldwide. Diabetes screening using saliva alternate to blood and urine could assist diabetes testing among the public. Aims and Objectives: To assess and establish the relationship of 1, 5-anhydroglucitol (1, 5-AG) in blood and saliva among DM and normal control subjects. Materials and Methods: A total of 30 subjects (G1) comprising hemoglobin A1C (HbA1C) confirmed type 2 DM and HbA1C confirmed 30 healthy controls (G2) were selected. Blood and whole saliva collected from G1 and G2 subjects centrifuged, aliquoted, and subjected to mass spectrometry. Quantification of 1, 5-AG in blood and saliva samples by liquid chromatography and mass spectrometry was conducted. The results obtained were subjected to statistical analysis. Results: Statistical analysis of data depicted G1 with lower salivary, serum 1, 5-AG levels compared to G2. Moderate positive correlation between salivary 1, 5-AG levels and serum 1, 5-AG levels in G1 and G2 observed. Conclusion: Serum 1, 5-AG levels could be predicted using the salivary 1, 5-AG levels. Therefore, 1, 5-AG in saliva could be predicted as a salivary biomarker in Type II DM patients.