Journal of Diabetes Research / 2016 / Article / Tab 3

Review Article

Xerostomia, Hyposalivation, and Salivary Flow in Diabetes Patients

Table 3

Salivary flow rate/hyposalivation studies.

Author, publication year, countryStudy population (DM/CG)Mean age (years) DM/CGType of diabetesDM diagnosisType and QFR mL/minDefinition of hyposalivation Hyposalivation in DM/CG%Significant associationMatched variables (DM/CG)JBI scoring

() Studies in adults T1DM

Edblad et al.
2001, Sweden [13]
41/41 
(i) DM: Department of Paediatrics, Medical Centre Hospital. T1DM since childhood 
(ii) CG: randomly chosen from the Swedish register 
(iii) WCDM: ≤ 8% () 
(iv) PCDM: > 8% ()
21 (1.6)/21 (1.6)T1DMNSSWS (paraffin, spitting method) 
(i) DM: 1.30 
(ii) PCDM: 1.31 
(iii) WCDM: 1.24 
(iv) CG: 1.54
Nonsignificant (NS)Age 
Gender 
Living in the same county
6

() Studies in adults IDDM

Ben-Aryeh et al.
1988, Israel [22]
35/31 
(i) DM: Consecutive patients from diabetes service and research unit 
(ii) CG: healthy volunteers from the hospital staff who were taking no drugs including oral contraceptives
31.2 ± 7.4/29 ± 6.2IDDMNSUWS (spitting method) 0.35 ± 0.24/0.48 ± 0.23Yes 
()
Age 
Gender
2

() Studies in adults T2DM

Lasisi and Fasanmade 
2012, Nigeria [15]
20/20 
(i) DM: endocrine unit of the medical outpatients department, University College 
(ii) CG: members of the university community
58.4 ± 10.6/50.2 ± 9.2T2DMNSUWS (spitting method) 
0.5/0.75
Yes  
()
Gender3

Vasconcelos et al.
2010, Brazil [7]
40/40  
(i) DM: endocrinology service of center for specialized medical care 
(ii) CG: Stomatology Clinic of School of Dentistry 
(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
57.7 ± 8.9/50.2 ± 12.3T2DMNSUWS and SWS (spitting method)  
(i) UWS: 0.21 ± 0.16/0.33 ± 0.20 
(ii) SWS: 0.63 ± 0.43/1.20 ± 0.70
UWS < 0.1 mL/min 
SWS < 0.5 mL/min
45%/2.5%Yes 
(i) UWS  
() 
(ii) SWS  
() 
(iii) Hyposalivation ()
Gender 
Age
3

de Lima et al.
2008, Brazil [16]
30/30 
(i) DM/CG: University Dental School
(ii) Wearing complete maxillary or maxillary and mandibular dentures.
60 (9)/63 (12)T2DMFasting blood glucose 
DM ≥ 126 mg/dL
SWS 0.95 (0.61)/1.14 (0.87)SWS < 0.7 mL/minNSNonsignificant 
()
Gender 
Age 
Race
3

Bernardi et al.
2007, Brazil [8]
82/18 
(i) DM: diabetic care unit of a local hospital 
(ii) CG: oral health center (same city) 
(iii) Those using total prostheses and mouth breathers were excluded.
(iv) WCDM: ≤ 8% (23%) 
(v) PCDM: > 8% (77%)
PC 54.3 ± 10.1; 
WC 63.6 ± 12.3; 
CG 57.7 ± 15.6
T2DMWHO criteria 
Fasting blood glucose 
DM ≥ 126 mg/dL 
CG < 110 mg/dL
SWS (spitting method),  
(i) PCDM: 0.65 ± 0.62 
(ii) WCDM: 0.81 ± 0.47 
(iii) CG: 1.95 ± 0.73
Yes 
SWS ()
Age4

Dodds et al.
2000, USA [17]
243/240 
(i) DM/CG: Participants in the Oral Health San Antonio Longitudinal Study of Aging 
(ii) CG: those subjects who reported no major health problems and were not taking any medications, other than vitamins or occasional analgesics.
Age is specified by sex per group 
(i) Female: 61.2 (37–78)/55.3 (37–78) 
(ii) Male: 63.9 (39–78)/55.9 (36–79)
T2DMModified WHO criteria 
Fasting blood glucose ≥ 126 mg/dL or currently taking diabetic medications
UWS 0.36/0.44 
SSP 0.28/036 
USS 0.08/0.12  
SSS 0.31/0.41
UWS and USP: nonsignificant; USS and SSS: significantly reduced in DMNS5

Chavez et al.
2000, USA [18]
29/23 
(i) DM: community-living and geriatric center  
(ii) CG: geriatric center 
(iii) Only dentate adults 
(iv) WCDM: ≤ 9% () 
(v) PCDM: ≥ 9% ()
(i) Mean age NS  
(ii) Divided into ≤ 71 years (14/9) and > 71 years (15/14)
T2DMBlood glucose levels ≥ 140 g/dL at 2 hours after oral glucose tolerance testDM/CG/WCDM/PCDM 
UWS (spitting method) 0.26 ± 0.29/0.16 ± 0.21/0.14 ± 0.13/0.17 ± 0.25 
USP 0.04 ± 0.04/0.04 ± 0.04/0.03 ± 0.02/0.04 ± 0.05 
SSP 0.31 ± 0.25/0.21 ± 0.17/0.29 ± 0.19/0.16 ± 0.15
Nonsignificant (DM/CG) 
Nonsignificant (CG/WCDM/PCDM)
Age 
Gender 
Race
2

() Studies in children and adolescents T1DM

Alves et al.
2012, Brazil [19]
51/51 
(i) DM: paediatric endocrinology service of hospital 
(ii) CG: NS 
glycemic control was established by the determination of glycated haemoglobin concentration
11.3 ± 3.4/11.9 ± 3.4T1DMAmerican Diabetes Association criteria (2010)UWS (spitting method) 0.26 ± 0.14/0.41 ± 0.28UWS < 0.3 mL/minNSYes  
UWS  
()
Socioeconomic status 
Lived in the same area
2

Javed et al.
2009, Pakistan [12]
48/40 
(i) DM: diabetic care unit of a local hospital 
(ii) CG: oral health centre 
(iii) Smokers, hepatitis B or C, AIDS, HIV, and narcotic drug used are excluded 
(iv) WCDM: levels < 6.5 () 
(v) PCDM: levels ≥ 6.5 ()
15 (10–19)/14.6 (10–19)T1DMNSUWS (spitting method)  
(i) DM: 0.2 (0.1–0.4) mL/min 
(ii) WCDM: 0.2 (0.1–0.4) mL/min 
(iii) PCDM: 0.1 (0.1–0.3) mL/min 
(iv) GC: 0.5 (0.3–0.7) mL/min
DM/CG, yes  
(UWS ) 
WCDM/PCDM, nonsignificant
Socioeconomic status3

() Studies in children and adolescents IDDM

López et al.
2003, Argentina [20]
20/21 
(i) DM: hospital endocrinology service 
(ii) CG: NS 
(iii) CG: absence of active disease, no history of drug treatment or therapy within the previous months, and no history of diabetes
9.4 ± 3.9/8.3 ± 1.8IDDMNSUWS = saliva 5 min production collected with sterile syringe 
No stimulation or spitting 
0.15 ± 0.11/0.25 ± 0.13
Yes (NS)Gender 
Socioeconomic status 
Tanner publeral state between I and III
1

Belazi et al.
1998, Greece [21]
10/10 
(i) DM: newly diagnosed diabetic children, Diabetic Department of Paediatric Clinic University Hospital 
(ii) CG: NS 
(iii) DM/CG: free from any other acute or systemic disease
6.8 (4–15)/10.5 (5–17)IDDMNSUWS (spitting method), 0.79 ± 0.46/1.06 ± 0.37NSNonsignificant ()NS1

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.