Visiting the Dentist May Help Diagnose Prediabetes

Abstract

Diabetes is a well known risk factor for periodontal and dental diseases. Despite increasing diabetes awareness, up to a third of diabetes cases remain undiagnosed. We assumed that a visit at the dentist’s is an opportunity to assess one’s glucose tolerance. We conducted a nationwide cross-sectional study evaluating whether a dentist can help diagnose diabetes in at-risk subjects. The study was performed between March and June 2017. Thirty dental surgeries across the country participated in the study. Each surgery was given 20 laboratory referral notes for free fasting plasma glucose (FPG) measurement to be handed over to 20 consecutive eligible individuals who gave their consent to take part in the study. The referred patients were asked to perform FPG test during the following 4 weeks. The study inclusion criteria were: age ≥18 years, any degree of any dental or periodontal disease, presence of at least one diabetes risk factor (i.e., BMI ≥25 kg/m2, family history of diabetes, sedentary lifestyle, past gestational diabetes, hypertension, dyslipidemia, cardiovascular disease, policystic ovary syndrome) and negative history of any glucose intolerance. Out of 600 referred patients, 469 (78.2%, 330 [70.4%] women, mean [±SD] age 53.7±15.4 years) had FPG assessed. Mean FPG in all subjects was 97.2±20.9 mg/dl (range 63-377 mg/dl). In 140 subjects (29.9% of those tested and 23.3% of those referred) impaired fasting glucose (IFG; i.e., FPG ≥100 and <126 mg/dl) was diagnosed. 19 subjects had FPG ≥126 mg/dl. IFG subjects were older than those with normal FPG: 60.1±12.6 vs. 50.9±15.7 years (p<0.001), and were more often men (40% vs. 27%; p<0.01). Odds ratio for IFG in subjects aged ≥60 vs. those <60 years was 3.413 (95% CI 2.215-5.264). In conclusion, approx. every fourth patient with at least one diabetes risk factor visiting the dentist’s presents with IFG. Dentists should be concerned about prediabetes particularly in their male patients aged ≥60. Increasing diabetes awareness among the dentists may help diagnose prediabetes and thus further prevent diabetes. Disclosure L. Czupryniak: Speaker's Bureau; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company. Advisory Panel; Self; Boehringer Ingelheim Pharmaceuticals, Inc., Eli Lilly and Company. Speaker's Bureau; Self; Novo Nordisk A/S. Advisory Panel; Self; Novo Nordisk A/S. Speaker's Bureau; Self; Merck Sharp & Dohme Corp., Merck & Co., Inc., Polpharma, Servier. E. Szymanska-Garbacz: Speaker's Bureau; Self; Sanofi, Eli Lilly and Company, Novo Nordisk A/S, Boehringer Ingelheim Pharmaceuticals, Inc., Medtronic MiniMed, Inc., Merck & Co., Inc. P. Bijos: Employee; Self; Teva Pharmaceutical Industries Ltd..