Keyes Triad in Type 2 Diabetes Mellitus: A Microbiological Study.

Area of Science:

• Oral microbiology
• Endocrinology
• Dental research

Background:

• Type 2 diabetes mellitus (DM) is increasingly prevalent worldwide.
• Elevated salivary glucose in DM may foster cariogenic microorganisms like *Streptococcus mutans* and *Lactobacillus acidophilus*.
• Assessing this link is crucial for understanding DM-related oral health complications.

Purpose of the Study:

• To investigate the correlation between salivary glucose levels and the presence of *S. mutans* and *L. acidophilus* in patients with type 2 DM.
• To determine if elevated salivary glucose in DM patients contributes to increased caries risk.
• To evaluate the relationship in diabetic patients with and without caries compared to healthy controls.

Main Methods:

• A cohort of 45 patients was divided into three groups: type 2 DM with caries, type 2 DM without caries, and healthy controls.
• Saliva samples were analyzed for glucose concentration using the glucose oxidase-peroxidase method.
• Bacterial swabs were cultured on selective media for *S. mutans* and *L. acidophilus*.

Main Results:

• A strong positive correlation was observed between salivary glucose and both *S. mutans* and *L. acidophilus* in diabetic patients with caries (r=0.858 and r=0.853, respectively).
• In diabetic patients without caries, a significant correlation was found only with *S. mutans* (r=0.705), but not *L. acidophilus* (r=0.387).
• No statistically significant correlation was found in the healthy control group.

Conclusions:

• Salivary glucose levels are a reliable indicator of an individual's diabetic state.
• Diabetic individuals exhibit a 1.7 times higher caries susceptibility, linked to increased salivary glucose.
• Elevated salivary glucose contributes to a higher cariogenic load in diabetic patients, necessitating potential modifications to oral hygiene strategies.