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AACE 2015: Dental Office Screening Identifies Diabetes, Pre-Diabetes

Score proposed to help facilitate diagnosis among population that infrequently sees primary physicians…

As a part of campaigns to alleviate the health and financial burdens of undiagnosed diabetes, and because many Americans regularly visit their dentists, but not medical doctors, diabetes screening in dental offices has emerged as a promising screening opportunity.

A study was conducted to design and validate a dental-office-friendly screening score (survey) as an effective strategy for early detection of prediabetes (PreDM) and early diabetes (DM) in dental patients.

Consecutive adult dental patients attending a private dental practice in Holt, Michigan, without history of PreDM or DM, were given a customized 14-question survey designed by Susan Maples, DDS. Subsequently they underwent finger sticks for A1c measurement, using a unique, validated capillary testing, performed at the NGSP’s Laboratory in Columbia, Missouri.

A total of 500 patients completed the study, 302 women and 198 men, with a mean age of 48 years. The prevalence rates of PreDM and DM were 19.2% and 1.2%, respectively. Predictors of PreDM or DM included age; above 10% ideal body weight; waist size above 40” for men or 35” for women; hypertension; abnormal lipids; tingling of hands or feet; and visual symptoms or conditions (blurring; cataracts; glaucoma).

The study confirmed findings of prior studies affirming the effectiveness of the dental office in detection of undiagnosed PreDM and DM. The rate of undiagnosed PreDM in this study was in keeping with other studies, and with the general population risk. However, the low rate of DM is believed to be due to demographic causes, as well as to the unique health preventive and educational activities of the study’s dental practice. In addition, this uniquely designed study introduces a newly developed customized PreDM and DM screening tool designed for dental offices. This newly introduced screening survey requires no body weighing or BMI calculation, considered inconvenient and undesirable in dental offices. This may assist the dental care provider in determining when it is appropriate screen for PreDM/DM, and to apply a simple screening test for DM/PreDM, such as point of care A1c measurement.

The researchers concluded that a newly developed simplified and dental office-friendly screening score be proposed for use in dental offices. Dental offices encounter a significant proportion of the population, who do not regularly visit their physicians. Given the high rates of undiagnosed PreDM and DM in the general population, such dental patients with potentially similar risk, would therefore otherwise remain undiagnosed.

Practice Pearls:

  • Findings from a prospective study of 500 consecutive patients who completed a 14-question diabetes risk survey in their dentists’ office.
  • The 14-item survey asked responders to answer ‘yes’ or ‘no’ to questions designed to assess diabetes risk.
  • Making the dentist part of the diabetes team can have huge rewards in improving the quality of life of those with diabetes.

Aldasouqui SA. “Diabetes detection in the dental office (DIDDO): A promising emerging opportunity for screening for undiagnosed prediabetes and diabetes” AACE 2015.