Xerostomia, Hyposalivation, and Salivary Flow in Diabetes Patients
Identifieur interne : 003128 ( Pmc/Curation ); précédent : 003127; suivant : 003129Xerostomia, Hyposalivation, and Salivary Flow in Diabetes Patients
Auteurs : Rosa María L Pez-Pintor [Espagne] ; Elisabeth Casa As [Espagne] ; José González-Serrano [Espagne] ; Julia Serrano [Espagne] ; Lucía Ramírez [Espagne] ; Lorenzo De Arriba [Espagne] ; Gonzalo Hernández [Espagne]Source :
- Journal of Diabetes Research [ 2314-6745 ] ; 2016.
Abstract
The presence of xerostomia and hyposalivation is frequent among diabetes mellitus (DM) patients. It is not clear if the presence of xerostomia and hyposalivation is greater in DM than non-DM patients. The aims of this systematic review are (1) to compare the prevalence rates of xerostomia, (2) to evaluate the salivary flow rate, and (3) to compare the prevalence rates of hyposalivation in DM versus non-DM population. This systematic review was conducted according to the PRISMA group guidelines by performing systematic literature searches in biomedical databases from 1970 until January 18th, 2016. All studies showed higher prevalence of xerostomia in DM patients in relation to non-DM population, 12.5%–53.5% versus 0–30%. Studies that analyzed the quantity of saliva in DM population in relation to non-DM patients reported higher flow rates in non-DM than in DM patients. The variation flow rate among different studies in each group (DM/CG) is very large. Only one existing study showed higher hyposalivation prevalence in DM than non-DM patients (45% versus 2.5%). In addition, quality assessment showed the low quality of the existing studies. We recommend new studies that use more precise and current definitions concerning the determination and diagnosis of DM patients and salivary flow collection.
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DOI: 10.1155/2016/4372852
PubMed: 27478847
PubMed Central: 4958434
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28040 Madrid</wicri:regionArea></affiliation></author><author><name sortKey="Casa As, Elisabeth" sort="Casa As, Elisabeth" uniqKey="Casa As E" first="Elisabeth" last="Casa As">Elisabeth Casa As</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, 28040 Madrid, Spain</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, 28040 Madrid</wicri:regionArea></affiliation></author><author><name sortKey="Gonzalez Serrano, Jose" sort="Gonzalez Serrano, Jose" uniqKey="Gonzalez Serrano J" first="José" last="González-Serrano">José González-Serrano</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, 28040 Madrid, Spain</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, 28040 Madrid</wicri:regionArea></affiliation></author><author><name sortKey="Serrano, Julia" sort="Serrano, Julia" uniqKey="Serrano J" first="Julia" last="Serrano">Julia Serrano</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, 28040 Madrid, Spain</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, 28040 Madrid</wicri:regionArea></affiliation></author><author><name sortKey="Ramirez, Lucia" sort="Ramirez, Lucia" uniqKey="Ramirez L" first="Lucía" last="Ramírez">Lucía Ramírez</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, 28040 Madrid, Spain</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, 28040 Madrid</wicri:regionArea></affiliation></author><author><name sortKey="De Arriba, Lorenzo" sort="De Arriba, Lorenzo" uniqKey="De Arriba L" first="Lorenzo" last="De Arriba">Lorenzo De Arriba</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, 28040 Madrid, Spain</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, 28040 Madrid</wicri:regionArea></affiliation></author><author><name sortKey="Hernandez, Gonzalo" sort="Hernandez, Gonzalo" uniqKey="Hernandez G" first="Gonzalo" last="Hernández">Gonzalo Hernández</name><affiliation wicri:level="1"><nlm:aff id="I1">Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, 28040 Madrid, Spain</nlm:aff><country xml:lang="fr">Espagne</country><wicri:regionArea>Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, 28040 Madrid</wicri:regionArea></affiliation></author></analytic><series><title level="j">Journal of Diabetes Research</title><idno type="ISSN">2314-6745</idno><idno type="eISSN">2314-6753</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p>The presence of xerostomia and hyposalivation is frequent among diabetes mellitus (DM) patients. It is not clear if the presence of xerostomia and hyposalivation is greater in DM than non-DM patients. The aims of this systematic review are (1) to compare the prevalence rates of xerostomia, (2) to evaluate the salivary flow rate, and (3) to compare the prevalence rates of hyposalivation in DM versus non-DM population. This systematic review was conducted according to the PRISMA group guidelines by performing systematic literature searches in biomedical databases from 1970 until January 18th, 2016. All studies showed higher prevalence of xerostomia in DM patients in relation to non-DM population, 12.5%–53.5% versus 0–30%. Studies that analyzed the quantity of saliva in DM population in relation to non-DM patients reported higher flow rates in non-DM than in DM patients. The variation flow rate among different studies in each group (DM/CG) is very large. Only one existing study showed higher hyposalivation prevalence in DM than non-DM patients (45% versus 2.5%). 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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Diabetes Res</journal-id><journal-id journal-id-type="iso-abbrev">J Diabetes Res</journal-id><journal-id journal-id-type="publisher-id">JDR</journal-id><journal-title-group><journal-title>Journal of Diabetes Research</journal-title></journal-title-group><issn pub-type="ppub">2314-6745</issn><issn pub-type="epub">2314-6753</issn><publisher><publisher-name>Hindawi Publishing Corporation</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">27478847</article-id><article-id pub-id-type="pmc">4958434</article-id><article-id pub-id-type="doi">10.1155/2016/4372852</article-id><article-categories><subj-group subj-group-type="heading"><subject>Review Article</subject></subj-group></article-categories><title-group><article-title>Xerostomia, Hyposalivation, and Salivary Flow in Diabetes Patients</article-title></title-group><contrib-group><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0002-5727-0920</contrib-id><name><surname>López-Pintor</surname><given-names>Rosa María</given-names></name><xref ref-type="aff" rid="I1"></xref><xref ref-type="corresp" rid="cor1"><sup>*</sup></xref></contrib><contrib contrib-type="author"><name><surname>Casañas</surname><given-names>Elisabeth</given-names></name><xref ref-type="aff" rid="I1"></xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0003-1060-5305</contrib-id><name><surname>González-Serrano</surname><given-names>José</given-names></name><xref ref-type="aff" rid="I1"></xref></contrib><contrib contrib-type="author"><contrib-id contrib-id-type="orcid" authenticated="false">http://orcid.org/0000-0002-4460-3183</contrib-id><name><surname>Serrano</surname><given-names>Julia</given-names></name><xref ref-type="aff" rid="I1"></xref></contrib><contrib contrib-type="author"><name><surname>Ramírez</surname><given-names>Lucía</given-names></name><xref ref-type="aff" rid="I1"></xref></contrib><contrib contrib-type="author"><name><surname>de Arriba</surname><given-names>Lorenzo</given-names></name><xref ref-type="aff" rid="I1"></xref></contrib><contrib contrib-type="author"><name><surname>Hernández</surname><given-names>Gonzalo</given-names></name><xref ref-type="aff" rid="I1"></xref></contrib></contrib-group><aff id="I1">Department of Oral Medicine and Surgery, School of Dentistry, Complutense University, 28040 Madrid, Spain</aff><author-notes><corresp id="cor1">*Rosa María López-Pintor: <email>rosamlpm@yahoo.es</email></corresp><fn fn-type="other"><p>Academic Editor: Rafael A. Delgado-Ruiz</p></fn></author-notes><pub-date pub-type="ppub"><year>2016</year></pub-date><pub-date pub-type="epub"><day>10</day><month>7</month><year>2016</year></pub-date><volume>2016</volume><elocation-id>4372852</elocation-id><history><date date-type="received"><day>15</day><month>4</month><year>2016</year></date><date date-type="accepted"><day>31</day><month>5</month><year>2016</year></date></history><permissions><copyright-statement>Copyright © 2016 Rosa María López-Pintor et al.</copyright-statement><copyright-year>2016</copyright-year><license xlink:href="https://creativecommons.org/licenses/by/4.0/"><license-p>This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><p>The presence of xerostomia and hyposalivation is frequent among diabetes mellitus (DM) patients. It is not clear if the presence of xerostomia and hyposalivation is greater in DM than non-DM patients. The aims of this systematic review are (1) to compare the prevalence rates of xerostomia, (2) to evaluate the salivary flow rate, and (3) to compare the prevalence rates of hyposalivation in DM versus non-DM population. This systematic review was conducted according to the PRISMA group guidelines by performing systematic literature searches in biomedical databases from 1970 until January 18th, 2016. All studies showed higher prevalence of xerostomia in DM patients in relation to non-DM population, 12.5%–53.5% versus 0–30%. Studies that analyzed the quantity of saliva in DM population in relation to non-DM patients reported higher flow rates in non-DM than in DM patients. The variation flow rate among different studies in each group (DM/CG) is very large. Only one existing study showed higher hyposalivation prevalence in DM than non-DM patients (45% versus 2.5%). In addition, quality assessment showed the low quality of the existing studies. We recommend new studies that use more precise and current definitions concerning the determination and diagnosis of DM patients and salivary flow collection.</p></abstract></article-meta></front><floats-group><fig id="fig1" orientation="portrait" position="float"><label>Figure 1</label><caption><p>Flowchart of the systematic review process.</p></caption><graphic xlink:href="JDR2016-4372852.001"></graphic></fig><table-wrap id="tab1" orientation="portrait" position="float"><label>Table 1</label><caption><p>JBI critical appraisal checklist for studies reporting prevalence data.</p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Assessment items</th><th align="left" rowspan="1" colspan="1">Yes</th><th align="left" rowspan="1" colspan="1">No</th><th align="left" rowspan="1" colspan="1">Unclear</th><th align="left" rowspan="1" colspan="1">Not applicable</th></tr></thead><tbody><tr><td align="left" rowspan="1" colspan="1">(1) Was the sample representative of the target population?</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1">(2) Were study participants recruited in an appropriate way?</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1">(3) Was the sample size adequate?</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1">(4) Were the study subjects and the setting described in detail?</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1">(5) Was the data analysis conducted with sufficient coverage of the identified sample?</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1">(6) Were objective, standard criteria used for the measurement of the condition?</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1">(7) Was the condition measured reliably?</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1">(8) Was there appropriate statistical analysis?</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1">(9) Are all important confounding factors/subgroups/differences identified and accounted for?</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr><tr><td align="left" rowspan="1" colspan="1">(10) Were subpopulations identified using objective criteria</td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td><td align="center" rowspan="1" colspan="1"> </td></tr></tbody></table></table-wrap><table-wrap id="tab2" orientation="portrait" position="float"><label>Table 2</label><caption><p>Xerostomia prevalence studies. </p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Author, publication year, country</th><th align="left" rowspan="1" colspan="1">Study population (DM/CG)</th><th align="left" rowspan="1" colspan="1">Mean age (years) DM/CG</th><th align="left" rowspan="1" colspan="1">Type of diabetes</th><th align="left" rowspan="1" colspan="1">DM diagnosis</th><th align="left" rowspan="1" colspan="1">Definition of xerostomia</th><th align="left" rowspan="1" colspan="1">Xerostomia DM/CG%</th><th align="left" rowspan="1" colspan="1">Significant association</th><th align="left" rowspan="1" colspan="1">Matched variables (DM/CG)</th><th align="left" rowspan="1" colspan="1">JBI scoring</th></tr></thead><tbody><tr><td colspan="10" align="center" rowspan="1">(1) <italic>Studies in adults T2DM</italic></td></tr><tr><td align="center" colspan="10" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Vasconcelos et al. 2010,<break></break> Brazil [<xref rid="B7" ref-type="bibr">7</xref>]</td><td align="left" rowspan="1" colspan="1">40/40 <break></break>(i) DM: endocrinology service of center for specialized medical care <break></break>(ii) CG: Stomatology Clinic of School of Dentistry <break></break>(iii) Smokers, drinkers, pregnant, edentulous, receptors of salivary gland surgery, radiotherapy of the head and neck region, Sjögren syndrome, rheumatoid arthritis, or lupus erythematosus excluded</td><td align="left" rowspan="1" colspan="1">57.7 ± 8.9/50.2 ± 12.3</td><td align="left" rowspan="1" colspan="1">T2DM</td><td align="left" rowspan="1" colspan="1">NS</td><td align="left" rowspan="1" colspan="1">Does your mouth feel dry frequently?</td><td align="left" rowspan="1" colspan="1">12.5%/2.5%</td><td align="left" rowspan="1" colspan="1">No</td><td align="left" rowspan="1" colspan="1">Gender <break></break>Age</td><td align="left" rowspan="1" colspan="1">3</td></tr><tr><td align="center" colspan="10" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Bernardi et al. 2007,<break></break> Brazil [<xref rid="B8" ref-type="bibr">8</xref>]</td><td align="left" rowspan="1" colspan="1">82/18 <break></break>(i) DM: diabetic care unit of a local hospital <break></break>(ii) CG: oral health center (same city) <break></break>(iii) Those using total prostheses and mouth breathers were excluded. <break></break>(iv) WCDM: HbA1<sub>c</sub> ≤ 8% (23%) <break></break>(v) PCDM: HbA1<sub>c</sub> > 8% (77%)</td><td align="left" rowspan="1" colspan="1">PC 54.3 ± 10.1; <break></break>WC 63.6 ± 12.3; CG 57.7 ± 15.6</td><td align="left" rowspan="1" colspan="1">T2DM</td><td align="left" rowspan="1" colspan="1">WHO criteria 2006 <break></break>Fasting blood glucose levels ≥ 126 mg/dL</td><td align="left" rowspan="1" colspan="1">Does your mouth usually feel dry? </td><td align="left" rowspan="1" colspan="1">52.43%/0% <break></break>WCDM = 47% <break></break>PCDM = 54%</td><td align="left" rowspan="1" colspan="1">Yes <break></break><italic>p</italic> = 0.0001</td><td align="left" rowspan="1" colspan="1">Age</td><td align="left" rowspan="1" colspan="1">4</td></tr><tr><td align="center" colspan="10" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Sandberg et al. 2001,<break></break> Sweden [<xref rid="B10" ref-type="bibr">10</xref>], and Sandberg et al. 2000,<break></break> Sweden [<xref rid="B9" ref-type="bibr">9</xref>]</td><td align="left" rowspan="1" colspan="1">102/102 <break></break>(i) DM: diabetes register in Primary Health Care <break></break>(ii) CG: Public dental service clinics as the diabetic patients visited for the clinical examination</td><td align="left" rowspan="1" colspan="1">64.8 ± 8.4/64.9 ± 8.5</td><td align="left" rowspan="1" colspan="1">T2DM</td><td align="left" rowspan="1" colspan="1">NS</td><td align="left" rowspan="1" colspan="1">Patient's subjective feeling of dry mouth</td><td align="left" rowspan="1" colspan="1">53.5%/28.4%</td><td align="left" rowspan="1" colspan="1">Yes <break></break><italic>p</italic> = 0.0003</td><td align="left" rowspan="1" colspan="1">Age <break></break>Gender</td><td align="left" rowspan="1" colspan="1">5</td></tr><tr><td align="center" colspan="10" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Chavez et al. 2000,<break></break> USA [<xref rid="B18" ref-type="bibr">18</xref>]</td><td align="left" rowspan="1" colspan="1">29/23 <break></break>(i) DM: community-living and geriatric center <break></break>(ii) CG: geriatric center <break></break>(iii) Only dentate adults <break></break>(iv) WCDM: HbA1<sub>c</sub> ≤ 9% (<italic>n</italic> = 11) <break></break>(v) PCDM: HbA1<sub>c</sub> ≥ 9% (<italic>n</italic> = 18)</td><td align="left" rowspan="1" colspan="1">(i) Mean age NS <break></break>(ii) Divided into ≤71 years (14/9) and >71 years (15/14)</td><td align="left" rowspan="1" colspan="1">T2DM</td><td align="left" rowspan="1" colspan="1">Blood glucose levels ≥ 140 mg/dL at 2 hours after oral glucose tolerance test</td><td align="left" rowspan="1" colspan="1">Does your mouth frequently feel dry? <break></break>Does your mouth feel dry when you are eating a meal? <break></break>Do you have difficulties swallowing foods if you eat without additional fluids?</td><td align="left" rowspan="1" colspan="1">Data not shown</td><td align="left" rowspan="1" colspan="1">No</td><td align="left" rowspan="1" colspan="1">Age <break></break>Gender <break></break>Race distribution</td><td align="left" rowspan="1" colspan="1">2</td></tr><tr><td align="center" colspan="10" rowspan="1"><hr></hr></td></tr><tr><td colspan="10" align="center" rowspan="1">(2) <italic>Studies in adults NIDDM</italic></td></tr><tr><td align="center" colspan="10" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Zielinski et al. 2002,<break></break> USA [<xref rid="B11" ref-type="bibr">11</xref>]</td><td align="left" rowspan="1" colspan="1">32/40 <break></break>(i) DM/CG: Center for Aging at the University Medicine and Dentistry School <break></break>(ii) Dentate patients with no fewer than 10 teeth present. Patients with a diagnosis of severe dementia and those taking anticoagulants, needing antibiotic prophylaxis or taking antibiotics on the day of examination were excluded.</td><td align="left" rowspan="1" colspan="1">71 ± 7/74 ± 8</td><td align="left" rowspan="1" colspan="1">NIDDM</td><td align="left" rowspan="1" colspan="1">NS</td><td align="left" rowspan="1" colspan="1">Does your mouth frequently feel dry? <break></break>Does your mouth feel dry when you are eating a meal? <break></break>Do you have difficulties swallowing foods if you eat without additional fluids? <break></break>Response ≥ 2 diagnosis of dry mouth</td><td align="left" rowspan="1" colspan="1">50%/30%</td><td align="left" rowspan="1" colspan="1">No <break></break><italic>p</italic> = 0.08</td><td align="left" rowspan="1" colspan="1">Gender <break></break>Age <break></break>Diuretics Antidepressants use </td><td align="left" rowspan="1" colspan="1">3</td></tr><tr><td align="center" colspan="10" rowspan="1"><hr></hr></td></tr><tr><td colspan="10" align="center" rowspan="1">(3) <italic>Studies in children and adolescents T1DM</italic></td></tr><tr><td align="center" colspan="10" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Javed et al. 2009, <break></break>Pakistan [<xref rid="B12" ref-type="bibr">12</xref>]</td><td align="left" rowspan="1" colspan="1">48/40 <break></break>(i) DM: diabetic care unit of a local hospital <break></break>(ii) CG: oral health centre <break></break>(iii) Smokers, hepatitis B or C, AIDS, HIV, and narcotic drug used are excluded <break></break>(iv) WCDM: HbA1<sub>c</sub> levels < 6.5 (<italic>n</italic> = 12) <break></break>(v) PCDM: HbA1<sub>c</sub> levels ≥ 6.5 (<italic>n</italic> = 36)</td><td align="left" rowspan="1" colspan="1">15 (10–19)/14.6 (10–19)</td><td align="left" rowspan="1" colspan="1">T1DM</td><td align="left" rowspan="1" colspan="1">NS</td><td align="left" rowspan="1" colspan="1">Does your mouth usually feel dry, especially during meals?</td><td align="left" rowspan="1" colspan="1">WCDM = 80% <break></break>PCDM = 100% <break></break>CG = 0%</td><td align="left" rowspan="1" colspan="1">Yes (DM/CG)</td><td align="left" rowspan="1" colspan="1">Socioeconomic status</td><td align="left" rowspan="1" colspan="1">3</td></tr></tbody></table><table-wrap-foot><fn><p>DM, diabetes mellitus; WCDM, well controlled diabetes mellitus; PCDM, poorly controlled diabetes mellitus; CG, control group; T1DM, type 1 diabetes mellitus; T2DM, type 2 diabetes mellitus; NIDDM, non-insulin-dependent diabetes mellitus; JBI, Joanna Briggs Institute Prevalence Critical Appraisal Tool. </p></fn></table-wrap-foot></table-wrap><table-wrap id="tab3" orientation="portrait" position="float"><label>Table 3</label><caption><p>Salivary flow rate/hyposalivation studies. </p></caption><table frame="hsides" rules="groups"><thead><tr><th align="left" rowspan="1" colspan="1">Author, publication year, country</th><th align="left" rowspan="1" colspan="1">Study population (DM/CG)</th><th align="left" rowspan="1" colspan="1">Mean age (years) DM/CG</th><th align="left" rowspan="1" colspan="1">Type of diabetes</th><th align="left" rowspan="1" colspan="1">DM diagnosis</th><th align="left" rowspan="1" colspan="1">Type and QFR mL/min</th><th align="left" rowspan="1" colspan="1">Definition of hyposalivation </th><th align="left" rowspan="1" colspan="1">Hyposalivation in DM/CG%</th><th align="left" rowspan="1" colspan="1">Significant association</th><th align="left" rowspan="1" colspan="1">Matched variables (DM/CG)</th><th align="left" rowspan="1" colspan="1">JBI scoring</th></tr></thead><tbody><tr><td colspan="11" align="center" rowspan="1">(1) <italic>Studies in adults T1DM</italic></td></tr><tr><td align="center" colspan="11" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Edblad et al. <break></break>2001, Sweden [<xref rid="B13" ref-type="bibr">13</xref>]</td><td align="left" rowspan="1" colspan="1">41/41 <break></break> (i) DM: Department of Paediatrics, Medical Centre Hospital. T1DM since childhood <break></break> (ii) CG: randomly chosen from the Swedish register <break></break> (iii) WCDM: HbA1<sub>c</sub> ≤ 8% (<italic>n</italic> = 26) <break></break> (iv) PCDM: HbA1<sub>c</sub> > 8% (<italic>n</italic> = 15)</td><td align="left" rowspan="1" colspan="1">21 (1.6)/21 (1.6)</td><td align="left" rowspan="1" colspan="1">T1DM</td><td align="left" rowspan="1" colspan="1">NS</td><td align="left" rowspan="1" colspan="1">SWS (paraffin, spitting method) <break></break> (i) DM: 1.30 <break></break> (ii) PCDM: 1.31 <break></break> (iii) WCDM: 1.24 <break></break> (iv) CG: 1.54</td><td align="left" rowspan="1" colspan="1">—</td><td align="left" rowspan="1" colspan="1">—</td><td align="left" rowspan="1" colspan="1">Nonsignificant (NS)</td><td align="left" rowspan="1" colspan="1">Age <break></break>Gender <break></break>Living in the same county</td><td align="left" rowspan="1" colspan="1">6</td></tr><tr><td align="center" colspan="11" rowspan="1"><hr></hr></td></tr><tr><td colspan="11" align="center" rowspan="1">(2) <italic>Studies in adults IDDM</italic></td></tr><tr><td align="center" colspan="11" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Ben-Aryeh et al. <break></break>1988, Israel [<xref rid="B24" ref-type="bibr">22</xref>]</td><td align="left" rowspan="1" colspan="1">35/31 <break></break> (i) DM: Consecutive patients from diabetes service and research unit <break></break> (ii) CG: healthy volunteers from the hospital staff who were taking no drugs including oral contraceptives</td><td align="left" rowspan="1" colspan="1">31.2 ± 7.4/29 ± 6.2</td><td align="left" rowspan="1" colspan="1">IDDM</td><td align="left" rowspan="1" colspan="1">NS</td><td align="left" rowspan="1" colspan="1">UWS (spitting method) 0.35 ± 0.24/0.48 ± 0.23</td><td align="left" rowspan="1" colspan="1">—</td><td align="left" rowspan="1" colspan="1">—</td><td align="left" rowspan="1" colspan="1">Yes <break></break> (<italic>p</italic> = 0.036)</td><td align="left" rowspan="1" colspan="1">Age <break></break>Gender</td><td align="left" rowspan="1" colspan="1">2</td></tr><tr><td align="center" colspan="11" rowspan="1"><hr></hr></td></tr><tr><td colspan="11" align="center" rowspan="1">(3) <italic>Studies in adults T2DM</italic></td></tr><tr><td align="center" colspan="11" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1"> Lasisi and Fasanmade <break></break>2012, Nigeria [<xref rid="B15" ref-type="bibr">15</xref>]</td><td align="left" rowspan="1" colspan="1">20/20 <break></break> (i) DM: endocrine unit of the medical outpatients department, University College <break></break> (ii) CG: members of the university community</td><td align="left" rowspan="1" colspan="1">58.4 ± 10.6/50.2 ± 9.2</td><td align="left" rowspan="1" colspan="1">T2DM</td><td align="left" rowspan="1" colspan="1">NS</td><td align="left" rowspan="1" colspan="1">UWS (spitting method) <break></break>0.5/0.75</td><td align="left" rowspan="1" colspan="1">—</td><td align="left" rowspan="1" colspan="1">—</td><td align="left" rowspan="1" colspan="1">Yes <break></break> (<italic>p</italic> = 0.04)</td><td align="left" rowspan="1" colspan="1">Gender</td><td align="left" rowspan="1" colspan="1">3</td></tr><tr><td align="center" colspan="11" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Vasconcelos et al. <break></break>2010, Brazil [<xref rid="B7" ref-type="bibr">7</xref>]</td><td align="left" rowspan="1" colspan="1">40/40 <break></break> (i) DM: endocrinology service of center for specialized medical care <break></break> (ii) CG: Stomatology Clinic of School of Dentistry <break></break> (iii) Smokers, drinkers, pregnant, edentulous, receptors of salivary gland surgery, radiotherapy of the head and neck region, Sjögren syndrome, rheumatoid arthritis, or lupus erythematosus excluded</td><td align="left" rowspan="1" colspan="1">57.7 ± 8.9/50.2 ± 12.3</td><td align="left" rowspan="1" colspan="1">T2DM</td><td align="left" rowspan="1" colspan="1">NS</td><td align="left" rowspan="1" colspan="1">UWS and SWS (spitting method) <break></break> (i) UWS: 0.21 ± 0.16/0.33 ± 0.20 <break></break> (ii) SWS: 0.63 ± 0.43/1.20 ± 0.70</td><td align="left" rowspan="1" colspan="1">UWS < 0.1 mL/min <break></break>SWS < 0.5 mL/min</td><td align="left" rowspan="1" colspan="1">45%/2.5%</td><td align="left" rowspan="1" colspan="1">Yes <break></break> (i) UWS <break></break> (<italic>p</italic> = 0.002) <break></break> (ii) SWS <break></break> (<italic>p</italic> = 0.0001) <break></break> (iii) Hyposalivation (<italic>p</italic> = 0.0001)</td><td align="left" rowspan="1" colspan="1">Gender <break></break>Age</td><td align="left" rowspan="1" colspan="1">3</td></tr><tr><td align="center" colspan="11" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">de Lima et al. <break></break>2008, Brazil [<xref rid="B16" ref-type="bibr">16</xref>]</td><td align="left" rowspan="1" colspan="1">30/30 <break></break> (i) DM/CG: University Dental School<break></break> (ii) Wearing complete maxillary or maxillary and mandibular dentures.</td><td align="left" rowspan="1" colspan="1">60 (9)/63 (12)</td><td align="left" rowspan="1" colspan="1">T2DM</td><td align="left" rowspan="1" colspan="1">Fasting blood glucose <break></break>DM ≥ 126 mg/dL</td><td align="left" rowspan="1" colspan="1">SWS 0.95 (0.61)/1.14 (0.87)</td><td align="left" rowspan="1" colspan="1">SWS < 0.7 mL/min</td><td align="left" rowspan="1" colspan="1">NS</td><td align="left" rowspan="1" colspan="1">Nonsignificant <break></break> (<italic>p</italic> = 0.331)</td><td align="left" rowspan="1" colspan="1">Gender <break></break>Age <break></break>Race</td><td align="left" rowspan="1" colspan="1">3</td></tr><tr><td align="center" colspan="11" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Bernardi et al. <break></break>2007, Brazil [<xref rid="B8" ref-type="bibr">8</xref>]</td><td align="left" rowspan="1" colspan="1">82/18 <break></break> (i) DM: diabetic care unit of a local hospital <break></break> (ii) CG: oral health center (same city) <break></break> (iii) Those using total prostheses and mouth breathers were excluded. <break></break> (iv) WCDM: HbA1<sub>c</sub>≤ 8% (23%) <break></break> (v) PCDM: HbA1<sub>c</sub> > 8% (77%)</td><td align="left" rowspan="1" colspan="1">PC 54.3 ± 10.1; <break></break>WC 63.6 ± 12.3; <break></break>CG 57.7 ± 15.6</td><td align="left" rowspan="1" colspan="1">T2DM</td><td align="left" rowspan="1" colspan="1">WHO criteria <break></break>Fasting blood glucose <break></break>DM ≥ 126 mg/dL <break></break>CG < 110 mg/dL</td><td align="left" rowspan="1" colspan="1">SWS (spitting method), <break></break> (i) PCDM: 0.65 ± 0.62 <break></break> (ii) WCDM: 0.81 ± 0.47 <break></break> (iii) CG: 1.95 ± 0.73</td><td align="left" rowspan="1" colspan="1">—</td><td align="left" rowspan="1" colspan="1">—</td><td align="left" rowspan="1" colspan="1">Yes <break></break> SWS (<italic>p</italic> = 0.001)</td><td align="left" rowspan="1" colspan="1">Age</td><td align="left" rowspan="1" colspan="1">4</td></tr><tr><td align="center" colspan="11" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Dodds et al.<break></break> 2000, USA [<xref rid="B17" ref-type="bibr">17</xref>]</td><td align="left" rowspan="1" colspan="1">243/240 <break></break> (i) DM/CG: Participants in the Oral Health San Antonio Longitudinal Study of Aging <break></break> (ii) CG: those subjects who reported no major health problems and were not taking any medications, other than vitamins or occasional analgesics.</td><td align="left" rowspan="1" colspan="1">Age is specified by sex per group <break></break> (i) Female: 61.2 (37–78)/55.3 (37–78) <break></break> (ii) Male: 63.9 (39–78)/55.9 (36–79)</td><td align="left" rowspan="1" colspan="1">T2DM</td><td align="left" rowspan="1" colspan="1">Modified WHO criteria <break></break>Fasting blood glucose ≥ 126 mg/dL or currently taking diabetic medications</td><td align="left" rowspan="1" colspan="1">UWS 0.36/0.44 <break></break>SSP 0.28/036 <break></break>USS 0.08/0.12 <break></break>SSS 0.31/0.41</td><td align="left" rowspan="1" colspan="1">—</td><td align="left" rowspan="1" colspan="1">—</td><td align="left" rowspan="1" colspan="1">UWS and USP: nonsignificant; USS and SSS: significantly reduced in DM</td><td align="left" rowspan="1" colspan="1">NS</td><td align="left" rowspan="1" colspan="1">5</td></tr><tr><td align="center" colspan="11" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Chavez et al. <break></break>2000, USA [<xref rid="B18" ref-type="bibr">18</xref>]</td><td align="left" rowspan="1" colspan="1">29/23 <break></break> (i) DM: community-living and geriatric center <break></break> (ii) CG: geriatric center <break></break> (iii) Only dentate adults <break></break> (iv) WCDM: HbA1<sub>c</sub> ≤ 9% (<italic>n</italic> = 11) <break></break> (v) PCDM: HbA1<sub>c</sub> ≥ 9% (<italic>n</italic> = 18)</td><td align="left" rowspan="1" colspan="1"> (i) Mean age NS <break></break> (ii) Divided into ≤ 71 years (14/9) and > 71 years (15/14)</td><td align="left" rowspan="1" colspan="1">T2DM</td><td align="left" rowspan="1" colspan="1">Blood glucose levels ≥ 140 g/dL at 2 hours after oral glucose tolerance test</td><td align="left" rowspan="1" colspan="1">DM/CG/WCDM/PCDM <break></break>UWS (spitting method) 0.26 ± 0.29/0.16 ± 0.21/0.14 ± 0.13/0.17 ± 0.25 <break></break>USP 0.04 ± 0.04/0.04 ± 0.04/0.03 ± 0.02/0.04 ± 0.05 <break></break>SSP 0.31 ± 0.25/0.21 ± 0.17/0.29 ± 0.19/0.16 ± 0.15</td><td align="left" rowspan="1" colspan="1">—</td><td align="left" rowspan="1" colspan="1">—</td><td align="left" rowspan="1" colspan="1">Nonsignificant (DM/CG) <break></break>Nonsignificant (CG/WCDM/PCDM) </td><td align="left" rowspan="1" colspan="1">Age <break></break>Gender <break></break>Race</td><td align="left" rowspan="1" colspan="1">2</td></tr><tr><td align="center" colspan="11" rowspan="1"><hr></hr></td></tr><tr><td colspan="11" align="center" rowspan="1">(4) <italic>Studies in children and adolescents T1DM</italic></td></tr><tr><td align="center" colspan="11" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Alves et al. <break></break>2012, Brazil [<xref rid="B19" ref-type="bibr">19</xref>]</td><td align="left" rowspan="1" colspan="1">51/51 <break></break> (i) DM: paediatric endocrinology service of hospital <break></break> (ii) CG: NS <break></break>glycemic control was established by the determination of glycated haemoglobin concentration</td><td align="left" rowspan="1" colspan="1">11.3 ± 3.4/11.9 ± 3.4</td><td align="left" rowspan="1" colspan="1">T1DM</td><td align="left" rowspan="1" colspan="1">American Diabetes Association criteria (2010)</td><td align="left" rowspan="1" colspan="1">UWS (spitting method) 0.26 ± 0.14/0.41 ± 0.28</td><td align="left" rowspan="1" colspan="1">UWS < 0.3 mL/min</td><td align="left" rowspan="1" colspan="1">NS</td><td align="left" rowspan="1" colspan="1">Yes <break></break>UWS <break></break> (<italic>p</italic> = 0.02)</td><td align="left" rowspan="1" colspan="1">Socioeconomic status <break></break>Lived in the same area</td><td align="left" rowspan="1" colspan="1">2</td></tr><tr><td align="center" colspan="11" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Javed et al. <break></break>2009, Pakistan [<xref rid="B12" ref-type="bibr">12</xref>]</td><td align="left" rowspan="1" colspan="1">48/40 <break></break> (i) DM: diabetic care unit of a local hospital <break></break> (ii) CG: oral health centre <break></break> (iii) Smokers, hepatitis B or C, AIDS, HIV, and narcotic drug used are excluded <break></break> (iv) WCDM: HbA1<sub>c</sub> levels < 6.5 (<italic>n</italic> = 12) <break></break> (v) PCDM: HbA1<sub>c</sub> levels ≥ 6.5 (<italic>n</italic> = 36)</td><td align="left" rowspan="1" colspan="1">15 (10–19)/14.6 (10–19)</td><td align="left" rowspan="1" colspan="1">T1DM</td><td align="left" rowspan="1" colspan="1">NS</td><td align="left" rowspan="1" colspan="1">UWS (spitting method) <break></break> (i) DM: 0.2 (0.1–0.4) mL/min <break></break> (ii) WCDM: 0.2 (0.1–0.4) mL/min <break></break> (iii) PCDM: 0.1 (0.1–0.3) mL/min <break></break> (iv) GC: 0.5 (0.3–0.7) mL/min</td><td align="left" rowspan="1" colspan="1">—</td><td align="left" rowspan="1" colspan="1">—</td><td align="left" rowspan="1" colspan="1">DM/CG, yes <break></break> (UWS <italic>p</italic> = 0.01) <break></break>WCDM/PCDM, nonsignificant</td><td align="left" rowspan="1" colspan="1">Socioeconomic status</td><td align="left" rowspan="1" colspan="1">3</td></tr><tr><td align="center" colspan="11" rowspan="1"><hr></hr></td></tr><tr><td colspan="11" align="center" rowspan="1">(5) <italic>Studies in children and adolescents IDDM</italic></td></tr><tr><td align="center" colspan="11" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">López et al.<break></break> 2003, Argentina [<xref rid="B20" ref-type="bibr">20</xref>]</td><td align="left" rowspan="1" colspan="1">20/21 <break></break> (i) DM: hospital endocrinology service <break></break> (ii) CG: NS <break></break> (iii) CG: absence of active disease, no history of drug treatment or therapy within the previous months, and no history of diabetes</td><td align="left" rowspan="1" colspan="1">9.4 ± 3.9/8.3 ± 1.8</td><td align="left" rowspan="1" colspan="1">IDDM</td><td align="left" rowspan="1" colspan="1">NS</td><td align="left" rowspan="1" colspan="1">UWS = saliva 5 min production collected with sterile syringe <break></break>No stimulation or spitting <break></break>0.15 ± 0.11/0.25 ± 0.13</td><td align="left" rowspan="1" colspan="1">—</td><td align="left" rowspan="1" colspan="1">—</td><td align="left" rowspan="1" colspan="1">Yes (NS)</td><td align="left" rowspan="1" colspan="1">Gender <break></break>Socioeconomic status <break></break>Tanner publeral state between I and III</td><td align="left" rowspan="1" colspan="1">1</td></tr><tr><td align="center" colspan="11" rowspan="1"><hr></hr></td></tr><tr><td align="left" rowspan="1" colspan="1">Belazi et al. <break></break>1998, Greece [<xref rid="B21" ref-type="bibr">21</xref>]</td><td align="left" rowspan="1" colspan="1">10/10 <break></break> (i) DM: newly diagnosed diabetic children, Diabetic Department of Paediatric Clinic University Hospital <break></break> (ii) CG: NS <break></break> (iii) DM/CG: free from any other acute or systemic disease</td><td align="left" rowspan="1" colspan="1">6.8 (4–15)/10.5 (5–17)</td><td align="left" rowspan="1" colspan="1">IDDM</td><td align="left" rowspan="1" colspan="1">NS</td><td align="left" rowspan="1" colspan="1">UWS (spitting method), 0.79 ± 0.46/1.06 ± 0.37</td><td align="left" rowspan="1" colspan="1">NS</td><td align="left" rowspan="1" colspan="1">—</td><td align="left" rowspan="1" colspan="1">Nonsignificant (<italic>p</italic> = 0.17)</td><td align="left" rowspan="1" colspan="1">NS</td><td align="left" rowspan="1" colspan="1">1</td></tr></tbody></table><table-wrap-foot><fn><p>DM, diabetes mellitus; CG, control group; QFR, quantity of flow rate; NS, nonspecific; WC, well controlled; PC, poorly controlled; UWS, nonstimulated salivary flow; SWS, stimulated salivary flow; USP, nonstimulated parotid flow; SSP, stimulated parotid flow; USS, nonstimulated submandibular/sublingual flow; SSS, stimulated submandibular/sublingual flow; JBI, Joanna Briggs Institute Prevalence Critical Appraisal Tool. </p></fn></table-wrap-foot></table-wrap></floats-group></pmc></record>Pour manipuler ce document sous Unix (Dilib)
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