Estimation of Candida, Glycogen Content and Cytomorphometric Analysis of Oral Exfoliated Cells in Diabetes Mellitus - A Prospective Case Control Study.

Diabetes mellitus, a common chronic endocrine-metabolic condition causes cellular alterations in oral exfoliated cells. The present study aimed to assess the cytomorphometric changes, candidal carriage and glycogen content in oral exfoliated cells of type 2 diabetes mellitus (DM). The prospective study included a sample of 70 subjects divided equally into type 2 DM patients and healthy controls. Cytological smears obtained from the right buccal mucosa and dorsal surface of the tongue were stained using Papanicolaou stain for cytomorphometric analysis and Periodic Acid Schiff stain to detect glycogen. Data obtained was statistically analyzed using unpaired t and Pearson correlation test. The p-value of < 0.001 was considered significant. The mean nuclear area was significantly higher (p-value 0.00) in type 2 DM at both sites whereas the mean cytoplasmic area decreased which was significant in the tongue (p-value 0.00) only. Overall, the cytoplasmic to nuclear ratio was also decreased. A significant increase in PAS-positive cells was observed at both sites of type 2 DM as compared to the controls (p-value 0.00). The presence of candida was also higher in type 2 DM patients in both buccal mucosa and tongue. Diabetes mellitus can produce significant site specific cellular changes within the oral epithelium. These cytomorphometric changes along with glycogen content and candidal carriage provide a holistic picture of the oral mucosal cells in diabetic patients.