Buccal mucosal alterations: A mirror of diabetes mellitus

Abstract

Background: Oral exfoliative cytology can be used as a simple chairside investigation for microscopic study of Diabetes Mellitus. Exfoliative cytology gives an insight to the cellular changes occurring in the buccal mucosa of diabetic individuals, serving as a mirror for diabetes mellitus. Aim: To evaluate the qualitative changes in oral epithelial cells using exfoliative cytology and its correlation with glycosylated hemoglobin in patients with Type 2 Diabetes Mellitus. Materials and Methods: Study group consisted of 100 patients with Type 2 Diabetes. Approval from the ethics committee was taken. HbA1c was measured. Buccal smears were collected using exfoliative cytology and were subjected to Rapid Papanicolaou (PAP) stain. Smears were scrutinized under Leica Research Microscope. Individuals who smoke, are dependent on alcohol, or have malignancy were excluded to eliminate its effect on cellular shape and morphology. Statistical Analysis: Spearman Rank Correlation. Results: A statistically significant increase in cytological changes are seen in the buccal mucosa as the levels of glycosylated hemoglobin increase. Exfoliated buccal cells revealed micronuclei, enlarged nuclear area, and increased inflammatory cells. Conclusion: On the basis of the results obtained, a strong correlation exists between the levels of glycosylated hemoglobin and buccal mucosal alterations. We are encouraged to venture with a suggestion that exfoliative cytology can be significant as a chairside adjunctive diagnostic tool in the detection of Diabetes Mellitus, apart from regular standard tests.