ABSTRACT
Background: Saliva has the potential to be used as a noninvasive sample for testing hyperglycemia in diabetes mellitus. Serum 1,5-anhydroglucitol (1,5-AG) decreases with an increase in blood sugar >180 mg/dl. We hypothesized that salivary 1,5-AG can be used to identify blood sugar higher than 180 mg/dl using a novel biochemical method. Aim: This study aimed to develop a novel biochemical method for serum and salivary assessment of 1,5-AG and assess its correlation with postprandial blood sugar (PPBS) >180 mg/dl. Methodology: The study comprised 45 controls (healthy individuals) and 45 cases (type 2 diabetic patients with PPBS >180 mg/dl). Blood and salivary samples were collected according to the study protocol. A new method was developed for the quantification of 1,5-AG in serum and saliva using liquid chromatography-mass spectrometry. Results: The value of serum (mean -22.19 µg/ml and median -22.12 µg/ml) and salivary (mean -0.124 µg/ml and median -0.088 µg/ml) 1,5-AG was higher in healthy individuals compared to corresponding serum (mean -3.89 µg/ml and median -2.52 µg/ml) and salivary (mean -0.025 µg/ml and median - 0.025 µg/ml) levels in diabetics with PPBS >180 mg/dl. In diabetics, a significant negative correlation was noticed with PPBS levels and 1,5-AG levels in serum and saliva. Salivary 1,5-AG level <0.054 µg/ml had an 86.4% sensitivity and 87.2% specificity in predicting a blood sugar value >180 mg/dl. Conclusion: The results of our study suggest that the short-term glycemic marker 1,5-AG can be detected in saliva and can be useful as an adjunct marker in monitoring of glycemic status in diabetic patients.
ABSTRACT
Accidental detection of asymptomatic clinically suspicious lesions is a common occurrence in routine clinical examination of the oral cavity. In certain cases, these lesions may mimic benign lesions further adding to confusion. In this case report, we have discussed the case of a 51-year-old male patient with an asymptomatic palatal mass which was detected during a routine dental check-up and subsequently confirmed to be an adenoid cystic carcinoma (ACC) arising from the minor salivary glands. The patient underwent right partial maxillectomy followed by radiation therapy and has been disease-free for 6 years and is on follow-up. ACC is a malignant tumour of the salivary glands commonly occurring in the palate, characterized by a slow indolent growth phase, with a high predilection for late recurrences which can be local or systemic. This article describes the importance of recognizing this clinical entity as a differential diagnosis in the evaluation of asymptomatic palatal lesions to enable early diagnosis and institution of appropriate treatment to successfully treat the disease.