Nuclear Changes in Controlled and Uncontrolled Type-2 Diabetic Patients In Buccal Exfoliative Cytology Smears Using Pap And Giemsa Staining – A Comparative Study

Abstract

Background: Diabetes is a third leading cause of mortality and morbidity in the world. Oral exfoliative cytology may be a more appropriate adjunctive diagnostic tool in conditions like diabetes mellitus, where the invasive techniques lose viability. Exfoliative cytology helps to detect cellular aging, cell atrophy, alterations in nucleus and cytoplasm, binucleation and occasional karyorrhexis in type-2diabetic patients which proves to be a valuable tool for early diagnosis of diabetes.  The purpose of this research was to develop a new method for an early diagnosis of diabetes mellitus by exfoliative cytology using PAP stain and GIEMSA stains which is a nuclear specific stain. The aim of the study was to compare the exfoliative cytology of oral mucosa in controlled and uncontrolled type-2 diabetic patients using PAP stain and GIEMSA stain detect the nuclear and cytoplasmic changes. Materials And Methods: The smears were obtained from buccal mucosa of the mouth in total of 25 individuals out of which 10 are controlled (<120 mg/dl) and 10 are uncontrolled (>130 md/dl) diabetic patients and 5 normal individuals. These smear samples was obtained from the clinical lab of Saveetha Dental College. Results: The nuclear changes include nuclear bud, binucleate/micronucleate, karyolysis, increased nuclear cytoplasmic ratio & hyperchromatism. The binucleated cells were found to have higher differences between controlled & uncontrolled whereas karyorrhexis showed no significant changes between controlled & uncontrolled diabetes. Conclusion: This is a preliminary study conducted to analyse the potential interaction between the nuclear changes and the amount of genetic damage caused in diabetes. However, our result clearly demonstrated that  uncontrolled diabetic patients have significantly more genetic damage (in terms of MN frequency) compared to controlled diabetic patients. This indicates than MN may be a useful constituent in a panel of biomarkers for the risk of diabetes.