Gingival Crevicular Blood as a Potential Screening Tool: A Cross Sectional Comparative Study

• Published in: International journal of environmental research and public health Vol. 17; no. 20; p. 7356
• Main Authors: Rapone, Biagio, Ferrara, Elisabetta, Santacroce, Luigi, Topi, Skender, Converti, Ilaria, Gnoni, Antonio, Scarano, Antonio, Scacco, Salvatore
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 09.10.2020; MDPI
• Subjects: Adult; Aged; Asymptomatic; Blood Glucose - analysis; Correlation analysis; Cross-Sectional Studies; Diabetes; Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - diagnosis; Disease; Enzymes; Gingiva; Glucose; Gum disease; Health care; Hemoglobin; Humans; Mass Screening; Middle Aged; Periodontium; Plasma; Reproducibility of Results; Surveillance; United States > US; screening; glucose measurement; diabetes; periodontal disease; periodontitis
• ISSN: 1660-4601; 1661-7827; 1660-4601
• DOI: 10.3390/ijerph17207356

Background: Diabetes is known to be one of the major global epidemic diseases, significantly associated with mortality and morbidity worldwide, conferring a substantial burden to the health care system. The epidemiological transition of this chronic disease tends to worsen unless preventive health strategies are implemented. Appropriate screening devices and standardized methods are crucial to prevent this potentially inauspicious life condition. Currently, the glucometer is the conventional device employed for blood glucose level determination that outputs the blood glucose reading. Glucometer performed in the dental office may be an important device in screening diabetes, so it can be addressed during a periodontal examination. Because gingival blood is a useful source to detect the glucose level, the focus is placed on the opportunity that might provide valuable diagnostic information. This study aimed to compare gingival crevicular blood with finger-stick blood glucose measurements using a self-monitoring glucometer, to evaluate whether gingival crevicular blood could be an alternative to allow accurate chairside glucose testing. Methods: A cross-sectional comparative study was performed among a 31–67-year-old population. Seventy participants with diagnosed type 2 diabetes and seventy healthy subjects, all with positive bleeding on probing, were enrolled. The gingival crevicular blood was collected using a glucometer to estimate the blood glucose level and compared with finger-stick blood glucose level. Results: The mean capillary blood glucose and gingival crevicular blood levels from all samples were, respectively, 160.42 ± 31.31 mg/dL and 161.64 ± 31.56 mg/dL for diabetic participants and 93.51 ± 10.35 mg/dL and 94.47 ± 9.91 mg/dL for healthy patients. In both groups, the difference between gingival crevicular blood and capillary blood glucose levels was non-significant (P < 0.05). The highly significant correlation between capillary blood glucose and gingival crevicular blood (r = 0.9834 for diabetic patients and r = 0.8153 for healthy participants) in both the groups was found. Conclusions: Gingival crevicular blood test was demonstrated as a feasible and useful primary screening tool test for detecting diabetes and for glucose estimation in non-diabetic patients. Use of gingival crevicular blood for screening is an attractive way of identifying a reasonable option of finger-stick blood glucose measurement under the appropriate circumstances. Rapid assessment may precede diagnostic evaluation in diabetic as well as healthy patients with acute severe bleeding. In addition, gingival crevicular blood levels may be needed to monitor the diabetic output.