Equivalencia de HbA1c en sangre crevicular gingival comparada con sangre venosa en pacientes con diabetes mellitus tipo 2

Abstract

Introduction Diabetes mellitus (DM) is a chronic disease that encompasses a group of heterogeneous disorders with the common characteristic of glucose tolerance and a metabolism of altered carbohydrates and lipids. Different studies have evaluated the bidirectional relationship between DM and periodontal disease, either by direct or indirect mechanisms. HbA1c is available, allowing a rapid sample taking that can be used during the dental visit. Objective To establish the equivalence of the measurement of HbA1c in gingival crevicular blood of people with diabetes mellitus type 2, with the measurement of HbA1c in venous blood in patients with type 2 diabetes mellitus who attend the dental clinics of the Santo Tomás University campus Floridablanca. Materials and methods A study was conducted to evaluate diagnostic tests. A cross-section type sampling was carried out, in which 20 adults diagnosed with type 2 diabetes mellitus who attended the dental clinic of the Santo Tomas de Floridablanca University were evaluated. The percentage of glycosylated hemoglobin in venous blood and gingival crevicular blood in healthy tooth and tooth with periodontal pocket was evaluated. For quantitative variables, the calculation of means, medians and dispersion measures (SD, IR) was performed according to the normality analysis performed with the Shapiro Wilk test. The results of the two tests were compared by means of the Bland and Altman test. The intraclass correlation coefficient (ICC) was used to determine the reproducibility of the HbA1c measurement in crevicular and venous blood (in its continuous form). Results It was found that the intraclass correlation coefficients and the 95% confidence intervals of the HbA1c intake results between the three methods used obtained an almost perfect reproducibility, since the CCI ranged between 0.91 and 0.96. It is also observed that the average difference between the HbA1c measurements with each of the methods does not reach half a percentage point. The 95% agreement limits of Bland and Altman were approximately + - 1.5% for all methods. Conclusion HbA1C levels in crevicular blood compared to venous blood are concordant, which means that the HbA1C measurement using the portable device A1CNow can be used as a control method for diabetic patients during the dental visit. It is recommended to consider the present study as a pilot test for future investigations.