Dental Clinics as Potent Sources for Screening Undiagnosed Diabetes and Prediabetes

AlGhamdi, Ali Saad Thafeed; Bukhari, Sahar M.N.; Elias, Wael Y; Merdad, Khalid; Sonbul, Helal

doi:10.1097/maj.0b013e318287c96c

Cited by 24 publications

(28 citation statements)

References 35 publications

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“…Interestingly, and as synthesized in a 2018 systematic review [122], a significant proportion of dental patients denying having diabetes, namely almost one-third of dental patients both in Denmark [76], Saudi Arabia [123], and the US [124][125][126] actually had pre-diabetes or manifest diabetes; or were considered having high risk therefore [127]. In Great Britain, 29.5% were considered of moderate risk and 18.1% high risk for diabetes, for a total of 47.6% [128].…”

Section: 2mentioning

confidence: 98%

IDF Diabetes Atlas: Diabetes and oral health – A two-way relationship of clinical importance

Borgnakke

2019

Diabetes Research and Clinical Practice

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The current scientific evidence for the bi-directional associations between oral health and diabetes is summarized. The universal biologic mechanisms and demographic and behavioral risk drivers underlying these associations in both directions are also described. Dysglycemia, even slightly elevated blood sugar levels, adversely affects oral health, manifesting itself in several oral diseases and conditions. In the opposite direction, any oral infection with its subsequent local and systemic inflammatory responses adversely affects blood glucose levels. Moreover, painful, mobile, or missing teeth may lead to intake of soft food items representing a sub-optimal diet and hence poor nutrition, and thereby contribute to incident type 2 diabetes or to poorer glucose control in existing diabetes. Treatment of inflammation related oral conditions, such as non-surgical periodontal treatment and extraction of infected teeth, can lead to a clinically significant decrease in blood glucose levels. Attention to infectious oral diseases and referral to dental care professionals for treatment can therefore be an important novel tool for medical care professionals in preventing and managing diabetes mellitus. Dental professionals can detect unrecognized potential dysglycemia and refer for medical examination. Such interprofessional, patient centered care may contribute to improved health, wellbeing, and quality of life in people with diabetes.

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Section: 2mentioning

confidence: 98%

IDF Diabetes Atlas: Diabetes and oral health – A two-way relationship of clinical importance

Borgnakke

2019

Diabetes Research and Clinical Practice

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“…The flow chart in Fig. 1 Eight [7,22,38,[40][41][42][43][44] of the nine studies used a risk assessment tool or questionnaire in some capacity, but only one [39] used it as a prerequisite for risk stratification to be eligible for PoC screening. One study [22] did not report on the number of screen positives with the PoC screening.…”

Section: Resultsmentioning

confidence: 99%

“…Several studies have shown that health professionals from different specialities have contributed to the identification of DM [38,45,46]. The findings suggest that a significant proportion of dental patient can be identified as at risk of hyperglycaemia with PoC opportunistic screening.…”

Section: Poc Screening Test Outcomementioning

confidence: 99%

“…However, to minimize sampling and threshold variation between studies and make the results more informative, subgroup meta-analysis for the PoC screening was performed. Two of the studies [38,39] acted as a potential source of heterogeneity; the study done in Saudi Arabia identified nearly 40% of all those screened with the index test as having undiagnosed T2DM. The author mentioned the limitation that a large proportion of the samples were from the lower socio income group.…”

Section: Strength and Limitationsmentioning

confidence: 99%

“…Only one[38] of the nine-mentioned blinding (double), but still scored high on the risk of bias in patient selection process. Two studies included all the participants for the screening and diagnostic test; one of these[41] did not report the name of the diagnostic test done.…”

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confidence: 99%

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Prevalence of undiagnosed diabetes and pre-diabetes in the dental setting: A Systematic review and meta-analysis

Chinnasamy

Moodie

2020

Preprint

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Background With the close link between Diabetes Mellitus (DM)and periodontal disease dentists have an unrealized opportunity to make a chance discovery of a patient’s medical condition. Unlike in the medical setting, information on the Point-of-Care (PoC), opportunistic screening for DM in the dental setting is limited. To make a reliable estimate on the prevalence of undiagnosed type 2 diabetes mellitus (T2DM) and prediabetes among dental patients in the dental setting and to assist healthcare planners in making an informed decision, information on the disease frequency and strategies employed to address this issue are of paramount importance . As such, the objectives of this study is to summarize the data on the prevalence of undiagnosed T2DM and pre-diabetes amongst dental patients and further explore the effectiveness of the PoC screening and its implication for use in the dental setting. Methods A MEDLINE – PubMed, EMBASE, Web of Science and Cochrane library search was conducted with no time specification. Information on study characteristics and diagnostic parameters were retrieved for metaanalysis. All the studies were assessed for methodological quality using the QUADAS 2 tool. Proportions were presented in tables and Forrest plots. All statistical analysis was performed using the Medcalc software. Results Nine studies met the inclusion criteria. The proportion of dental patients identified to be at risk of hyperglycaemia with the PoC screening using random blood glucose, and glycated haemoglobin was 32.47% and 40.10%, whilst the estimated proportion with undiagnosed T2DM and pre-diabetes was identified as 11.23% and 47.38%. Conclusion A significant proportion of dental patient can be identified as undiagnosed T2DM and prediabetes. Targeted opportunistic screening is a feasible approach and can help reduce the prevalence of undiagnosed T2DM and pre-diabetes.

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Risk Assessment for Diabetes

Gray

2020

Risk Assessment in Oral Health

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Dental Clinics as Potent Sources for Screening Undiagnosed Diabetes and Prediabetes

Cited by 24 publications

References 35 publications

IDF Diabetes Atlas: Diabetes and oral health – A two-way relationship of clinical importance

IDF Diabetes Atlas: Diabetes and oral health – A two-way relationship of clinical importance

Prevalence of undiagnosed diabetes and pre-diabetes in the dental setting: A Systematic review and meta-analysis

Risk Assessment for Diabetes

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