Abstract
Objectives This article identifies undiagnosed DM (UDM) cases in the Pakistani population by
perceiving the signs and symptoms of DM and associating them with oral manifestations.
Material and Methods In this cross-sectional study, patients showing at least three or more classical
or warning signs like polydipsia, polyuria, polyphagia, and general weakness were
considered UDM cases. Detailed oral examination for gingivitis, periodontitis, halitosis,
xerostomia, and tongue manifestations was done followed by the hemoglobin A1c (HbA1c)
analysis.
Results Out of 5,878 patients, 214 UDM cases were identified, where 31.8% and 39.7% of the
patients were diagnosed as prediabetics and diabetics, respectively, based on HbA1c
analysis. Prevalence of gingivitis (97.6%), fissured tongue (91.8%), generalized periodontitis
(85.9%), thick saliva (87.1%), xerostomia (84.7%), burning mouth syndrome (63.5%),
yellow discoloration of tongue (57.6%), and ecchymosis/ulcers (43.5%) were more in
diabetics as compared to prediabetic patients and normal population.
Conclusion The oral manifestations can be crucial for identifying UDM cases. Dentists can play
a pivotal role by taking detailed history and thorough oral examination. If three
or more symptoms as concluded above are present, an HbA1c analysis should be conducted
to prevent preop and postop complications associated with DM.
Keywords
diabetes - prediabetes - HbA1c - fissured tongue - tongue manifestations
