Dental Practices Can Identify Patients With Undiagnosed Diabetes

Dentistry Today

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Dental practices could play a key role in the early detection of diabetes for thousands of patients each year and in every country worldwide, according to the DiabetRisk study.

After studying 1,143 adult patients at 41 dental practices across Spain, the researchers concluded that a simple screening protocol combining a Finnish Diabetes Risk Score (FINDRISC) questionnaire with an HbA1c blood test identified 96% of patients with undiagnosed diabetes or prediabetes during a dental visit.

Commissioned by the SEPA Research Network of Dental Clinics from the ETEP Research Group at Complutense University of Madrid and sponsored by Sunstar, the results of the three-year study have been released by the Spanish Society of Periodontology (SEPA) at a time when people with diabetes are more likely to suffer severe symptoms or complications from COVID-19.

Of the 1,143 patients, 97 or more than 8% were identified with undiagnosed diabetes or prediabetes. The study also found that using a FINDRISC questionnaire completed by each patient alone detected undiagnosed hyperglycemia with 87% accuracy.

The FINDRISC questionnaire evaluated risk factors such as age, consumption of fruit and vegetables, physical exercise, and family history of diabetes mellitus. Patients also received a basic periodontal examination. Complementing the questionnaire results with a chairside HbA1c test to provide an average blood glucose level for the previous two to three months increased the diagnosis accuracy to 96%.

The study also corroborated the link that patients with the worst cases of periodontal disease are more likely to have prediabetes or diabetes, the researchers said. Patients who suffer from both at the same time face an increased risk of developing complications from diabetes earlier, since periodontal disease is an inflammatory disease that can increase systemic inflammation. In turn, this promotes insulin resistance, impairing blood sugar control.

The DiabetRisk study demonstrates that a simple screening protocol combining the FINDRISC questionnaire and an HbA1c blood test is a simple, efficient, and affordable way to identify patients with early undiagnosed diabetes or prediabetes during a dental visit, the researchers said. Costs per patient for the screening protocol were approximately 10 Euros.

Importantly, the researchers added, early detection and treatment of diabetes significantly reduces the risk for cardiovascular morbidity and mortality in patients.

“These findings mean that in at least eight out of every 100 patients who went to a dental practice and had the screening, diabetes or prediabetes was detected,” said David Herrera, chief researcher for the DiabetRisk study and professor at Complutense University.

“Given the relationship between gum disease and diabetes, dental clinics are an ideal place for the early detection of this metabolic disease as demonstrated by our findings. It’s also widely accepted that while many patients don’t visit their doctor very regularly, a large proportion of the population do visit their dentist, enhancing the role of dental practices as a key ally in promoting general health,” Herrera said.

“We are very pleased to be involved in the DiabetRisk study, which has a number of important results and implications for dentists worldwide, and also demonstrates Sunstar’s longstanding commitment to promoting health and in preventing diabetes with dentists,” said Dr. Marzia Massignani, head of scientific affairs at Sunstar.

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