Oral medicine
Association between glycemic status and oral Candida carriage in patients with prediabetes

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Objective

This study assessed the association between glycemic status and oral Candida carriage among patients with prediabetes.

Study Design

This was a comparative study of oral Candida carriage among individuals with prediabetes. Oral yeast samples were collected from 150 individuals: group A was 43 patients with prediabetes (fasting blood glucose levels and hemoglobin A1c, 100 to 125 mg/dL and ≥5%, respectively); group B was 37 individuals previously considered prediabetic but having fasting blood glucose levels <100 mg/dL and hemoglobin A1c <5%; and group C was 70 medically healthy individuals. Oral yeasts were identified using standard techniques. Unstimulated whole salivary flow rate and number of missing teeth were recorded.

Results

Oral Candida was isolated from 100% of patients with prediabetes and from 65.7% of control participants. Candida albicans carriage was higher among patients with prediabetes (48.7%) (P < .01) and patients in group A (51.2%) (P < .01) than among controls (25.7%). Candida carriage, unstimulated whole salivary flow rate, and number of missing teeth were similar in groups A and B.

Conclusions

Oral Candida carriage was higher in patients with prediabetes than in controls and was independent of glycemic status in patients with prediabetes.

Section snippets

Ethical approval

The study was approved by the research ethics review committee of the Jinnah Postgraduate Medical Center, Karachi, Pakistan. The study was performed in accordance with the Declaration of Helsinki as revised in 2000. It was mandatory for all study participants to have read and signed the consent form before being included in this study.

Inclusion and exclusion criteria

Only individuals with medically diagnosed prediabetes (FBGL, 100-125 mg/dL [5.6-6.9 mmol/L]; hemoglobin A1c [HbA1c], 5.7%-6.4%) were included. Exclusion criteria

Characteristics of the study cohort

Eighty patients with prediabetes (43 patients [38 males and 5 females] in group A and 37 patients [35 males and 2 females] in group B) and 70 controls (61 males and 9 females) were included for study. There was no significant difference in age among participants in groups A (41.2 ± 1.6 years), B (43.1 ± 2.1 years), and C (40.6 ± 1.5 years). The mean duration of prediabetes among participants in groups A and B was 11 ± 2.2 months and 13.2 ± 1.4 months, respectively (Table I).

The mean FBGL was

Discussion

To our knowledge from indexed literature, this is the first study in which oral Candida carriage was investigated in patients with prediabetes with particular emphasis on glycemic status. In general, the population with prediabetes investigated in the present study was hyperglycemic (FBGL, 109.3 ± 4.2 mg/dL; HbA1c, 5.8 ± 0.2%), which is a possible explanation for the increased oral C albicans carriage in patients with prediabetes (n = 80) compared with healthy controls (70 individuals in group

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    The authors thank the College of Dentistry Research Center and Deanship of Scientific Research at King Saud University, Saudi Arabia, for funding this research project (Project FR 0072).

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