IADR Abstract Archives
Identifying Singaporean Dental Patients for Undiagnosed Diabetes Mellitus & Prediabetes
Objectives: Singapore has one of the highest incidences of diabetes among developed countries. Currently, 11.3% of Singapore residents aged 18-69 years have diabetes of which more than half (51.4%) were not aware of their condition during time of diagnosis. Undiagnosed diabetes (UD) is associated with significant morbidity and mortality. The bi-directional relationship between periodontitis and diabetes suggest the dental setting as a potential opportunity to identify patients with UD. The aim of this study was to screen for UD and prediabetes during dental visits.
Methods: 759 adults attending dental treatment and without history of diabetes were included in the study. Participants’ medical history and completion of a questionnaire modelled after the American Diabetes Association(ADA) Risk Test were recorded. A fingerstick blood droplet of each participant was obtained for point-of-care (POC) HbA1c (glycosylated haemoglobin) analysis and casual blood glucose measurements. Periodontal evaluation and charting was performed. Participants were given their POC casual blood glucose and HbA1c test results on the same visit and referred to a medical physician if the HbA1c status was above ADA guideline levels for diabetes.
Results: 47(6.2%) and 265(34.9%) individuals were identified with HbA1c levels corresponding to the ADA guideline levels for diabetes and prediabetes, respectively. Higher proportions of patients with UD were observed in severe periodontitis than in moderate periodontitis patients (P=0.001). They also had significantly higher mean number of pockets and percentage of pockets >3mm, and were more likely not yet commenced initial periodontal therapy compared to the control, mild or moderate periodontitis groups (p<0.001).
Conclusions: This study demonstrates that screening for UD and prediabetes can be feasibly performed by chairside recordings of HbA1c levels using a POC device and that the dental visit is a significant healthcare opportunity to screen periodontal patients at risk for diabetes thus enabling early medical intervention and hence reducing disease burden and complications.
Methods: 759 adults attending dental treatment and without history of diabetes were included in the study. Participants’ medical history and completion of a questionnaire modelled after the American Diabetes Association(ADA) Risk Test were recorded. A fingerstick blood droplet of each participant was obtained for point-of-care (POC) HbA1c (glycosylated haemoglobin) analysis and casual blood glucose measurements. Periodontal evaluation and charting was performed. Participants were given their POC casual blood glucose and HbA1c test results on the same visit and referred to a medical physician if the HbA1c status was above ADA guideline levels for diabetes.
Results: 47(6.2%) and 265(34.9%) individuals were identified with HbA1c levels corresponding to the ADA guideline levels for diabetes and prediabetes, respectively. Higher proportions of patients with UD were observed in severe periodontitis than in moderate periodontitis patients (P=0.001). They also had significantly higher mean number of pockets and percentage of pockets >3mm, and were more likely not yet commenced initial periodontal therapy compared to the control, mild or moderate periodontitis groups (p<0.001).
Conclusions: This study demonstrates that screening for UD and prediabetes can be feasibly performed by chairside recordings of HbA1c levels using a POC device and that the dental visit is a significant healthcare opportunity to screen periodontal patients at risk for diabetes thus enabling early medical intervention and hence reducing disease burden and complications.