Salivary factors in children and adolescents with insulin-dependent diabetes mellitus.

To determine whether hyperglycemia in IDDM (insulin-dependent diabetes mellitus) could interfere with salivary secretion rates, salivary glucose levels, and salivary microbial counts, we studied salivary factors in two groups of children and adolescents with IDDM. One study group included 14 children with newly diagnosed IDDM )mean age 11 years, SD +/- 2.4 years). Samples of saliva were collected on admission to hospital and after 2 weeks on insulin treatment. The other study group were 50 IDDM children (mean age 14.4 years, SD +/- 1.7 years, mean duration of diabetes 6.2 years, SD +/- 1.4 years) visiting the outpatient diabetic clinic. Samples of saliva were collected during two visits, approximately 3 months apart. In the newly diagnosed IDDM cases, mean salivary glucose level decreased from 54.1 +/- 31.7 mg/l to 35.2 +/- 29.5 mg/l (P = 0.096) after beginning insulin treatment. During hyperglycemia, salivary glucose levels correlated with mean blood glucose levels for the day concerned (r = 0.65, P < 0.05). The results suggest that high blood glucose levels can increase salivary glucose levels. Stimulated saliva secretion increased significantly from 5.4 +/- 3.3 ml/5 min to 7.3 +/- 2.6 ml/5 min (P < 0.01) while glucose balance improved. In the long-term IDDM cases, salivary flow rates and salivary glucose levels were not significantly related to the glycosylated hemoglobin (HbA1) values. Salivary glucose levels and salivary secretion rates were inversely correlated (P < 0.05). In conclusion, hyperglycemia was observed to be associated with decreased salivary secretion and high salivary glucose levels. As a consequence, salivary lactobacilli and yeast counts tended to increase.