Sammanfattning
Objective - The early diagnosis of (pre)diabetes mellitus
is essential for the prevention of diabetes complications.
It has been suggested that gum disease (periodontitis)
might be an early complication of diabetes and may be
a useful risk indicator for diabetes screening. Therefore,
a dental office could be a good location for screening for
(pre)diabetes in patients with periodontitis using a validated
glycated hemoglobin (HbA1c) dry spot analysis.
Research design and methods - A total of 313 individuals
from a university dental clinic participated. From 126
patients with mild/moderate periodontitis, 78 patients with
severe periodontitis and 109 subjects without periodontitis,
HbA1c values were obtained by the analysis of dry blood
spots. Differences in mean HbA1c values and the prevalence
of (pre)diabetes between the groups were analyzed.
Results - The mild/moderate and severe periodontitis
groups showed significantly higher HbA1c values (6.1%
±1.4% (43 mmol/mol±15 mmol/mol) and 6.3%±1.3%
(45 mmol/mol ± 15 mmol/mol), respectively) compared
with the control group (5.7%±0.7% (39 mmol/mol±8
mmol/mol), p=0.003). In addition, according to the American
Diabetes Association (ADA) guidelines for diagnosis,
there was a significant over-representation of subjects with
suspected diabetes (23% and 14%) and pre-diabetes
(47% and 46%) in the severe periodontitis group and mild/
moderate periodontitis groups, respectively, compared
with the control group (10% and 37%, p=0.010). Notably,
18.1% of patients with suspected new diabetes were
found among subjects with severe periodontitis compared
with 9.9% and 8.5% among subjects with mild/moderate
periodontitis and controls, respectively (p=0.024).
Conclusions - The dental office, with particular focus on
patients with severe periodontitis, proved to be a suitable
location for screening for (pre)diabetes; a considerable
number of suspected new diabetes cases were identified.
The early diagnosis and treatment of (pre)diabetes
help to prevent more severe complications and benefit
the treatment of periodontitis.