DOI: https://doi.org/10.36347/sjams.2025.v13i01.033

Pages: 208-214

Background: Glycemic control is crucial for managing type 2 diabetes mellitus (T2DM), with HbA1c being the gold standard for long-term monitoring. However, HbA1c has limitations, including its inability to reflect short-term glucose fluctuations and susceptibility to conditions like anemia. Salivary alpha-2 macroglobulin (A2MG), a non-invasive biomarker, has emerged as a potential alternative for assessing glycemic control. Objective: This study aimed to compare the efficacy of salivary A2MG and HbA1c in reflecting glycemic control among patients with T2DM in Bangladesh. Methodology: A cross-sectional study was conducted among 80 patients diagnosed with T2DM at Bangabandhu Sheikh Mujib Medical University, Dhaka, from March 2022 to February 2023. Participants were divided into adequately controlled (HbA1c <7%) and inadequately controlled (HbA1c ≥7%) groups. Salivary A2MG levels were measured using ELISA, while HbA1c was analyzed using an automated biochemistry analyzer. Statistical analyses included correlation and receiver operating characteristic (ROC) curve analysis to evaluate diagnostic performance. Results: Mean salivary A2MG levels were significantly higher in inadequately controlled patients (280.6 ± 161.7 ng/ml) compared to adequately controlled patients (83.6 ± 25.3 ng/ml, p<0.001). A strong positive correlation was observed between salivary A2MG and HbA1c (rho=0.738, p<0.001). ROC curve analysis demonstrated an area under the curve (AUC) of 0.915 for salivary A2MG, with a sensitivity of 85.4% and specificity of 81.3% at a cutoff value of 100.1 ng/ml. Conclusion: Salivary A2MG shows strong potential as a non-invasive biomarker for glycemic control, correlating significantly with HbA1c and offering high diagnostic accuracy. It provides a practical, cost-effective alternative for diabetes management, particularly in resource-limited settings.