Xerostomia, Hyposalivation, and Salivary Flow in Diabetes Patients

Table 3

Salivary flow rate/hyposalivation studies.

Author, publication year, country	Study population (DM/CG)	Mean age (years) DM/CG	Type of diabetes	DM diagnosis	Type and QFR mL/min	Definition of hyposalivation	Hyposalivation in DM/CG%	Significant association	Matched 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)	T1DM	NS	SWS (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 ± 6.2	IDDM	NS	UWS (spitting method) 0.35 ± 0.24/0.48 ± 0.23	—	—	Yes; ()	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 ± 9.2	T2DM	NS	UWS (spitting method); 0.5/0.75	—	—	Yes; ()	Gender	3
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 ± 12.3	T2DM	NS	UWS 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)	T2DM	Fasting blood glucose; DM ≥ 126 mg/dL	SWS 0.95 (0.61)/1.14 (0.87)	SWS < 0.7 mL/min	NS	Nonsignificant; ()	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	T2DM	WHO 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 ()	Age	4
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)	T2DM	Modified 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 DM	NS	5
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)	T2DM	Blood glucose levels ≥ 140 g/dL at 2 hours after oral glucose tolerance test	DM/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 ± 3.4	T1DM	American Diabetes Association criteria (2010)	UWS (spitting method) 0.26 ± 0.14/0.41 ± 0.28	UWS < 0.3 mL/min	NS	Yes; 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)	T1DM	NS	UWS (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 status	3
() 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 ± 1.8	IDDM	NS	UWS = 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)	IDDM	NS	UWS (spitting method), 0.79 ± 0.46/1.06 ± 0.37	NS	—	Nonsignificant ()	NS	1

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.