title: Efficacy of oral exfoliative cytology in diabetes mellitus patients: a light microscopic and confocal microscopic study.
abstract: Diabetes mellitus (DM) has become a global problem. By monitoring the health status of these individuals, diabetic complications can be prevented. We aimed to analyze alterations in the morphology and cytomorphometry of buccal epithelial cells of type 2 DM patients using oral exfoliative cytology technique and determine its importance in public health screening, diagnosis and monitoring of diabetes mellitus.
  
  
  
  The study was carried out in 100 type 2 DM patients and 30 healthy individuals. Smears were taken from the right buccal mucosa and stained by the Papanicolaou technique. Staining with Acridine orange was carried out to view qualitative changes with confocal laser scanning microscope (LSM-510 Meta). The cytomorphometry was evaluated using IMAGE PRO PLUS 5.5 software with Evolution LC camera. All findings were statistically analyzed.
  
  
  
  The results showed that with increase in fasting plasma glucose levels, there is significant increase in nuclear area, decrease in cytoplasmic area, and increase in nuclear cytoplasmic ratio (p < 0.05) when compared to the control group. Various qualitative changes were noted, such as cell degeneration, micronuclei, binucleation, intracytoplasmic inclusion, candida and keratinization.
  
  
  
  In the present study, we found significant alterations in the cytomorphometry and cytomorphology of buccal epithelial cells of type 2 DM patients. This study supports and extends the view that these cellular changes can alert the clinician to the possibility of diabetes and aid in monitoring of diabetes throughout the lifetime of the patient.
authors.affiliation: Assistant Professor, Department of Oral Pathology, Penang International Dental College, Penang, Malaysia, Phone: 0104651261, e-mail: drdeepikagopal@gmail.com.
authors.forename: Deepika
authors.initials: D
authors.lastname: Gopal
authors.affiliation: Department of Oral Pathology, Sri Ramachandra University, Chenai, Tamil Nadu, India.
authors.forename: N
authors.initials: N
authors.lastname: Malathi
authors.affiliation: Department of Prosthetic Dentistry, Penang International Dental College, Penang, Malaysia.
authors.forename: B Thirupathi
authors.initials: BT
authors.lastname: Reddy
mesh_terms: D000165:Acridine Orange; D001786:Blood Glucose / Q000032:analysis; D002175:Candida / Q000302:isolation & purification; D016923:Cell Death; D002467:Cell Nucleus / Q000648:ultrastructure; D003581:Cytodiagnosis / Q000379:methods*; D003593:Cytoplasm / Q000648:ultrastructure; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000473:pathology*; D004847:Epithelial Cells / Q000473:pathology; D005215:Fasting; D005456:Fluorescent Dyes; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D002479:Inclusion Bodies / Q000648:ultrastructure; D007633:Keratins; D008403:Mass Screening / Q000379:methods; D015162:Micronucleus Tests; D008853:Microscopy / Q000379:methods; D018613:Microscopy, Confocal / Q000379:methods; D009061:Mouth Mucosa / Q000473:pathology*; D009504:Neutrophils / Q000473:pathology; D065006:Papanicolaou Test / Q000379:methods
chemical_list: D001786:Blood Glucose; D005456:Fluorescent Dyes; D007633:Keratins; D000165:Acridine Orange
keywords: Confocal laser scanning microscope; Cytomorphometry; Diabetes mellitus; Oral exfoliative cytology.