Screening for type 2 diabetes and periodontitis patients (CODAPT-My©): a multidisciplinary care approach

Abstract

Background The practice of referring diabetic patients for dental intervention has been poor despite awareness and knowledge of the oral health effects of diabetes. Likewise, dentists treating patients receiving diabetes treatment are rarely updated on the glycaemic status and as a result, the opportunity for shared management of these patients is missed. This study aimed to provide a standardised care pathway which will initiate screening for diabetes from dental clinics and link patients with primary care for them to receive optimised care for glycaemic control. Method A Modified Delphi technique was employed to obtain consensus on recommendations, based on current evidence and best care practices to screen for diabetes among patients attending dental clinics for periodontitis. Expert panel members were recruited using snowball technique where the experts comprised Family Medicine Specialists (5), Periodontists (6), Endocrinologists (3) and Clinical Pharmacists (4) who are involved in management of patients with diabetes at public and private healthcare facilities. Care algorithms were designed based on existing public healthcare services. Results The CODAPT© panel recommends referral to primary care for further evaluation of glycaemic status if patients diagnosed with periodontitis record fasting capillary blood glucose levels ≥ 5.6 mmol/L. Intervention treatment options for prediabetes are listed, and emphasis on feedback to the dental healthcare team is outlined specifically. Conclusion The CODAPT© care pathway has the potential to link dental clinics with primary care for diagnosis and/or optimised treatment of prediabetes/diabetes among patients receiving periodontitis treatment.

A Case-Finding Protocol for High Cardiovascular Risk in a Primary Care Dental School—Model with Integrated Care

“…If dental schools or primary care dental practices wanted to run these clinics outside of a trial environment, they would be required to find funding, equipment and human resources. This study began to test for fasting glucose levels; indeed, others have performed similar studies, measuring blood glucose at the dentist [ 44 ]. It was interesting that here, we found a patient with uncontrolled diabetes despite the small population, and that patients wanted this additional measurement to be performed.…”

Team-Based Approach to Reduce Malignancies in People with Diabetes and Obesity

“…However, unlike diabetic foot ulcers, patients with T2DM have poor knowledge and awareness of the association between T2DM and oral health [ 3 ]. A “CODAPT-My Care” pathway connecting dental clinics with primary care discusses that members in the expert panel should comprise family medicine physicians, periodontists, endocrinologists, and clinical pharmacists [ 1 ]. An example of the prevention program, the Lifestyle Change plus Dental Care (LCDC), pays special attention to lifestyle changes and periodontal care to avoid dental complications [ 69 ].…”

“…Multidisciplinary teamwork has the features of coordination throughout treatment plan development, streamlined treatment pathways, and reduced duplication of services, resulting in increased survival rates, better treatments, and easier access to information for patients with T2DM [ 1 , 2 , 7 , 37 , 78 ]. Unfortunately, the clinical link between a team-based approach and the reduction of cancer risk has not been established; hence, further research is needed.…”