Trip Answers

Question answered:28/02/08

eMedicine has a chapter ‘Disorders of Taste and Smell’ [1].  This gives a large number of potential causes of gustatory dysfunction.  This is too large to reproduce here, but can be read via the URL below.

 

With regard to diabetics we found a number of studies which might be of interest.

 

A 2005 review [2] reported:

 

“This study reveals that diabetic uremic patients undergoing maintained hemodialysis exhibited a potentially higher risk for dental decay and xerostomia. Lower salivary pH and poor glycemic control may affect oral manifestations. Further research is needed to clarify the combined influence of diabetic nephropathy on oral health.“

 

Another paper relating to hemodialysis [3], concluded:

 

“We conclude that taste acuity is partially impaired in diabetic HD patients, and suggest this contributes to reduced appetite, leading to malnutrition and poor prognoses.”

 

A 1992 paper [4] reports:

 

“Taste impairment has been reported during the course of diabetes. Although a degenerative mechanism has been suspected, the natural history of taste disorders in diabetes remains unknown. The purpose of this study was to describe the five-year evolution of electric gustometry in diabetic patients compared to healthy control subjects and with reference to degenerative complications of the disease.”

 

The authors conclude:

 

“These results suggest that the taste nerves transduction function is impaired during the course of diabetes. This impairment is associated with an increased occurrence of degenerative complications, leading to suspect a similar pathophysiological mechanism. Electric gustometry could be an interesting test for early screening for diabetes complications.”

 

Finally, a 1995 paper’s abstract [5], states:

 

“Electrogustometry was performed in diabetics and the correlation between the electric gustatory threshold and clinical factors of the patients (age, disease period and diabetic complications) were evaluated (n = 50). The results obtained were as follows: 1. The electric gustatory threshold rose with aging. The patient age range for further analysis was confined to 50 approximately 69 years old (n = 34) to exclude age dependency. 2. The patients with longer disease histories tended to show a higher electric gustatory threshold, indicating that taste abnormalities in diabetics progress with disease duration. 3. Elevation of the electric gustatory threshold in diabetics was observed before onset or at the earliest stage of the three major complications (diabetic neuropathy, retinopathy and nephropatho), and the threshold rose further with the progression of diabetic complications. Thus, the electric gustatory threshold is a sensitive indicator of diabetic nephropathy and was demonstrated to be a remarkably useful indicator for the prevention of diabetic complications, since it allows detection of the three major diabetic complications at their earliest stages.”

 

For further information we recommend you discuss the case with a local diabetologist.

 

References

1) http://www.emedicine.com/ent/topic333.htm
2) http://www.ncbi.nlm.nih.gov/pubmed/15897855
3) http://www.ncbi.nlm.nih.gov/pubmed/12845237
4) http://www.ncbi.nlm.nih.gov/pubmed/1341446

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