Comparative Evaluation of the Efficacy of Gingival Crevicular Blood with Finger Capillary Blood and Venous Capillary Blood to Assess Blood Glucose Levels for Screening of Diabetes Mellitus in Chronic Periodontits Patients: A Cross-sectional Study

Abstract

Introduction: Diabetes mellitus is defined as a clinically and genetically diverse cluster of illnesses involving conflict in carbohydrate and protein metabolism. Periodontitis is a complex condition with several causes. The interaction between these two conditions appears to be cyclical as well as bidirectional. Gingival crevicular blood obtained through routine periodontal oral assessment could be utilised for blood glucose estimation. Aim: To examine the efficacy of gingival crevicular blood elicited during routine periodontal probing as a reliable source for screening of diabetes mellitus, and to compare it with finger capillary blood and venous capillary blood in chronic periodontitis patients. Materials and Methods: This cross-sectional, in-vivo, clinical study was conducted in the Department of Periodontology at Karnavati School of Dentistry, Gandhinagar, Gujarat, India, from January 2021 to January 2022. The study included 50 patients, who were diagnosed with chronic periodontitis in the age range ≥30 years, and met the inclusion and exclusion criteria. A prior detailed history was compiled. The clinical parameters recorded were sulcus bleeding index, plaque index, gingival index, probing pocket depth, and clinical attachment level. Each patient’s blood samples were collected from three different sites, Gingival Crevicular Blood (GCB) collected from gingival crevice, Finger Capillary Blood (FCB) collected from finger bed and and Venous Capillary Blood (VCB) collected from forearm for determining the blood glucose levels. Glucose levels were compared by oneway Analysis of Variance (ANOVA). Karl Pearson’s correlation was used for the comparison. Statistical Package for Social Sciences (SPSS) version 26.0 was used for statistical analysis and p-value ≤0.05 was considered as statistically significant. Results: The mean Probing Pocket Depth (PPD) and Clinical Attachment Level (CAL) was 5.5±0.61 mm and 6.76±0.82 mm, respectively. The mean Plaque Index (PI) and Gingival Index (GI) score was 1.41±0.25 and 1.45±0.21, respectively. The mean GCB, FCB, and VCB glucose level of the subjects were 171.58±85.63 mg/dL, 179.14 ±80.31 mg/dL and 186.96±87.57 mg/dL, respectively. There was no statistical difference seen among the three methods thus, either of the methods can be used for measuring blood glucose levels for screening of diabetes mellitus in chronic periodontitis patients (p-value= 0.66). Posistive correlation between FCB and VCB (r-value=0.976, p-value<0.001). VCB and GCB when correlated showed strong positive and highly statistically significant results (r-value= 0.934, p-value<0.001). Similarly, GCB and FCB showed a positive correlation (r-value=0.920, p-value<0.001) which was statistically highly significant. Conclusion: The results suggested that the efficacy of gingival crevicular blood when compared with finger capillary blood and venous capillary blood glucose levels showed positive correlation, suggesting either can be used in dental clinics for diabetic screening purpose without any extra invasive procedures.