Screening for diabetes mellitus in dental practices A field trial

Background. In this field trial, the authors assess the feasibility of screening for diabetes and prediabetes in dental practices and in a community health center. Methods. Dental patients 45 years and older who were not aware of their diabetic status underwent evaluation for diabetes risk with an American Diabetes Association Diabetes Risk Test and with hemoglobin (Hb) A(1c) measurement. Participants with an HbA(1c) level of 5.7 percent or greater were referred to their physicians for diagnosis. Results. Of the 1,022 patients screened, 416 (40.7 percent) had an HbA(1c) blood level of 5.7 percent or greater and were referred for diagnosis. The HbA(1c) and the American Diabetes Association Diabetes Risk Test were correlated (P<.001). Of the 416 participants who were referred, 35.1 percent received a diagnosis from their physicians within one year; 78.8 percent of these patients were seen in the community health center and 21.4 percent were seen in private dental offices. The diagnoses were diabetes (12.3 percent of patients), high risk of developing diabetes (that is, prediabetes) (23.3 percent) and no diabetes (64.4 percent). Conclusions. The study results show that screening for prediabetes and diabetes is feasible in a dental office, with acceptance by the dentist and dental office staff members, patients' physicians and patients. Patients from the community health center demonstrated good compliance with referrals to physicians; however, compliance was poor among those in the private dental offices. Practical Implications. Screening for diabetes and prediabetes in the dental office may provide an important benefit to patients and encourage interprofessional collaboration to achieve a chronic care model in which health care professionals work together to care for a panel of patients.