Dentists can help identify patients with diabetes or prediabetes who are unaware of their condition, according to researchers at the Columbia University College of Dental Medicine (Journal of Dental Research, April 29, 2011).
The researchers sought to develop and evaluate identification protocols for high blood sugar levels in dental patients. The study was supported by a research grant from Colgate-Palmolive.
"Periodontal disease is an early complication of diabetes, and about 70% of U.S. adults see a dentist at least once a year," stated senior author Ira Lamster, DDS, dean of the College of Dental Medicine, in a press release. "Prior research focused on identification strategies relevant to medical settings. Oral healthcare settings have not been evaluated before, nor have the contributions of oral findings ever been tested prospectively."
For the study, the researchers recruited 601 patients from a New York City dental clinic who were age 40 and older if non-Hispanic white or age 30 and older if Hispanic or nonwhite, and had never been diagnosed with diabetes or prediabetes.
Of the total patients, 535 patients with at least one self-reported diabetes risk factor (family history of diabetes, high cholesterol, hypertension, or overweight/obesity) received a periodontal examination and a fingerstick hemoglobin test. To assess and compare the performance of identification protocols, patients returned for a fasting plasma glucose test, which indicates whether the patient has diabetes or prediabetes.
In the at-risk dental population, a simple algorithm composed of only two dental parameters (number of missing teeth and percentage of deep periodontal pockets) was effective in identifying patients with unrecognized prediabetes or diabetes, the researchers found. The addition of the hemoglobin test was of significant value, further improving the performance of the algorithm.
"Early recognition of diabetes has been the focus of efforts from medical and public health colleagues for years, as early treatment of affected individuals can limit the development of many serious complications," said lead author Evanthia Lalla, DDS, associate professor at the College of Dental Medicine. "Relatively simple lifestyle changes in prediabetic individuals can prevent progression to frank diabetes, so identifying this group of individuals is also important," she added. "Our findings provide a simple approach that can be easily used in all dental care settings."
According to the Centers for Disease Control and Prevention, one in four people affected with type 2 diabetes in the U.S. remains undiagnosed. And those with prediabetes are at an increased risk for type 2 diabetes and also for heart disease, stroke, and other vascular conditions typical of individuals with diabetes.
