Abstract
The presence of xerostomia and hyposalivation is frequent among diabetes mellitus (DM) patients. It is not clear if the presence of xerostomia and hyposalivation is greater in DM than non-DM patients. The aims of this systematic review are (1) to compare the prevalence rates of xerostomia, (2) to evaluate the salivary flow rate, and (3) to compare the prevalence rates of hyposalivation in DM versus non-DM population. This systematic review was conducted according to the PRISMA group guidelines by performing systematic literature searches in biomedical databases from 1970 until January 18th, 2016. All studies showed higher prevalence of xerostomia in DM patients in relation to non-DM population, 12.5%–53.5% versus 0–30%. Studies that analyzed the quantity of saliva in DM population in relation to non-DM patients reported higher flow rates in non-DM than in DM patients. The variation flow rate among different studies in each group (DM/CG) is very large. Only one existing study showed higher hyposalivation prevalence in DM than non-DM patients (45% versus 2.5%). In addition, quality assessment showed the low quality of the existing studies. We recommend new studies that use more precise and current definitions concerning the determination and diagnosis of DM patients and salivary flow collection.
Highlights
Diabetes mellitus (DM) is an endocrine disease characterized by a deficit in the production of insulin with consequent alteration of the process of assimilation, metabolism, and balance of blood glucose concentration
This study showed that prevalence of xerostomia was greater in type 1 DM (T1DM) patients than non-T1DM patients (0%), and the prevalence was greater in poorly controlled DM (PCDM) patients (100%) than well controlled DM (WCDM) patients (80%)
There was only one study in adults T1DM [13]; this study showed that SWS flow rate was lower in DM versus non-DM patients, 1.30 versus 1.54 mL/min, and obtained higher salivary flow rate in PCDM than WCDM (1.31 versus 1.34 mL/min)
Summary
Diabetes mellitus (DM) is an endocrine disease characterized by a deficit in the production of insulin with consequent alteration of the process of assimilation, metabolism, and balance of blood glucose concentration. The global prevalence of DM has increased substantially, reaching 8.3% in 2014, which corresponds to 387 million patients [1]. T1DM accounts for approximately 5% of diagnosed diabetes cases [2]. Xerostomia is a subjective complaint of dry mouth, whereas hyposalivation is an objective decreased of salivary flow. Hyposalivation is considered to appear when salivary flow rates are under 0.1 mL/min at rest (UWS) or 0.7 mL/min under stimulation (SWS). Xerostomia is often associated with hyposalivation, but not always. Many cases of xerostomia have been described in patients with a normal salivary flow rate [3,4,5,6]
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