Flow rate and organic constituents of whole saliva in insulin-dependent diabetic children and adolescents.

The purpose of this investigation was to examine the association between control of diabetes and composition of whole saliva in insulin-dependent diabetic children. Thirty diabetic children and adolescents ages 4-19 years were matched by age, sex, and race to 30 healthy children. Metabolic control was determined for each diabetic child by percentage of glycosylated hemoglobin, HbA I. Fourteen children were judged to be well controlled (HbA~ < 10%); 16 were poorly controlled (HbA1 >_ 10%). Whole stimulated saliva was collected from each subject and flow rate was evaluated. Amount of glucose, total protein, IgG, IgA, lysozyme, peroxidase, and lactoferrin were analyzed for each subject. Analyses of covariance were performed to determine the relationship between subject group and factors in saliva. Well controlled and poorly controlled diabetic children demonstrated increased output of glucose to saliva. Poorly controlled diabetics had decreased flow of saliva and a significantly increased concentration of lactoferrin in whole saliva. The observed changes in composition of saliva in diabetic subjects suggested that poor control of diabetes may affect functioning of salivary glands. The complications of insulin-dependent diabetes affect most tissues of the body, but relatively few investigators have examined the complications of diabetes that may be manifested in salivary glands. Investigators have reported an altered flow and composition of saliva in adult diabetics’ and several studies have shown that experimental diabetes in laboratory animals causes structural and functional changes in salivary glands. 2 These documented effects of diabetes on salivary glands in adults and laboratory animals demonstrate a need for investigation of alterations in salivary glands associated with diabetes in children. Variation in concentration of constituents of saliva like glucose and proteins will Conner et al. 1970; Kjellman 1970a; Mandel and Baurmash 1978; Marder et al. 1975. Anderson and Johnson 1981; Anderson and Shapiro 1980; Muratsu indicate an effect of diabetes on functioning of salivary glands. Diabetic children offer a unique opportunity to study the association between diabetes and salivary gland function because children are less likely to suffer from other systemic disorders and are free of the degenerative processes associated with aging. The difficulty in maintaining metabolic control in diabetic children and adolescents, in addition to the severity of the disease, reinforces the need for examination of salivary gland function in diabetic children. This investigation was undertaken to study composition of whole saliva and functioning of salivary glands in insulin-dependent diabetic children. Materials and Methods