Screening of elevated glucose levels in gingival crevice blood using a novel, sensitive self-monitoring device

Med Princ Pract. 2004 Nov-Dec;13(6):361-5. doi: 10.1159/000080474.

Abstract

Objective: To test the feasibility of using gingival crevice blood (GCB) collected during routine periodontal examination to estimate blood glucose levels using a novel and very sensitive self-monitoring device (FreeStyle).

Subjects and methods: Forty-six patients (20 male, 26 female; age range 12-56 years, mean age 36 +/- 11 years) seeking dental treatment took part in the study. Three and 4 patients reported diabetes mellitus type 1 and 2, respectively; 24 had gingivitis, of which 22 were moderate or advanced periodontitis. Periodontal probing depth (PD) and clinical attachment loss was measured at 6 sites of every tooth present, and bleeding on probing (BOP) was recorded. A site with profuse BOP was chosen for glucose determination. Measurements in GCB were compared with those of conventional capillary fingerstick blood (CFB).

Results: Sufficiently large GCB volumes provided glucometer readings in 32 cases (range 1.17-10.00 mmol/l). The CFB readings ranged between 1.39 and 11.50 mmol/l. If low amounts of crevice blood prohibited a glucometer reading, significantly lower mean numbers of sites with BOP (26 vs. 67, p <0.001) and elevated PD > or =4 mm (2 vs. 21, p <0.05) were seen. Agreement between the two measurements was low, the mean difference was -1.22, and limits of agreement (1.96 times the standard deviation of differences) were +/-2.89 mmol/l.

Conclusion: The present study failed to provide any evidence for the usefulness of GCB for testing blood glucose during routine periodontal examination.

MeSH terms

  • Adolescent
  • Adult
  • Blood Glucose / analysis*
  • Blood Glucose Self-Monitoring / methods*
  • Child
  • Diabetes Mellitus / blood*
  • Diabetes Mellitus / diagnosis
  • Feasibility Studies
  • Female
  • Gingiva / blood supply*
  • Gingival Crevicular Fluid / chemistry*
  • Gingivitis / diagnosis
  • Humans
  • Male
  • Middle Aged
  • Outcome Assessment, Health Care
  • Regional Blood Flow

Substances

  • Blood Glucose