Oral glucose clearance in nonagenarians in relation to functional capacity,medication and oral variables

Objectives: To study oral sugar (glucose) clearance and to examine some factors which were believed to either influence or be dependent upon oral glucose clearance. Design: Cross-sectional, clinical study with analysis of records. Setting: Göteborg gerontological and geriatric population studies, Göteborg University, Sweden. Subjects: 71 community-dwelling individuals, 27 men and 44 women, of a representative sample of 260 92-year-old persons. Intervention and Main outcome measures : Glucose concentration was measured in saliva after chewing of a glucose tablet and the clearance was assessed by three different variables: (i) the initial salivary glucose concentration, (ii) the area under the curve (AUC) and (iii) the clearance time. Results: The glucose clearance showed a wide inter-individual variation, which could be explained partly by differences in oral state, chewing time, stimulated salivary secretion rate and medication use. A positive correlation was found between the clearance variables and the number of lactobacilli and mutans streptococci in saliva and the percentage of untreated root caries lesions of the total number of exposed root surfaces. Conclusions : A slow oral sugar clearance is more common among 92-year-olds than younger adults earlier reported in other studies, particularly in those who have uncompensated functional impairments and a high medication history. A decreased oral glucose clearance was associated with high counts of salivary lactobacilli and mutans streptococci and a high proportion of untreated root caries lesions.