Abstract
Objectives
This study aimed to examine feasibility of testing and frequency of abnormal plasma glucose among dental patients in The Dental Practice-Based Research Network.
Methods
Eligible dental patients were ≥19 years old and had at least one American Diabetes Association-defined risk factor for diabetes mellitus or an existing diagnosis of diabetes or pre-diabetes. Random (fasting not required) plasma glucose was measured in standardized fashion using a commercial glucometer. Readings <70 or >300 mg/dl triggered re-testing. Patients with glucose ≥126 mg/dl were referred for medical follow-up.
Results
Of 498 subjects in 28 dental practices, 491 (98 %) consented and 418 (85.1 %) qualified for testing. Fifty-one patients (12.2 %) had diabetes; 24 (5.7 %) had pre-diabetes. Glucose ranged from 50 to 465 mg/dl. One hundred twenty-nine subjects (31 %) had readings outside the normal range; of these, 28 (6.7 %) had readings <80 mg/dl and 101 (24.2 %) had readings ≥126 mg/dl; in nine patients (seven with diabetes), glucose was >200 mg/dl.
Conclusions
A significant proportion of patients tested had abnormal blood glucose. Routine glucose testing in dental practice of populations at risk or diagnosed with diabetes may be beneficial and community dental practices hold promise as settings for diabetes and pre-diabetes screening and monitoring.
Clinical relevance
Results suggest that implementation of glucose measurement in dental practice may provide important clinical and health information for both patients and practitioners.
Similar content being viewed by others
References
Veeranna V, Ramesh K, Zalawadiya SK et al (2011) Glycosylated hemoglobin and prevalent metabolic syndrome in nondiabetic multiethnic U.S. adults. Metab Syndr Relat Disord 9(5):361–367
Mealey BL, Oates TW (2006) Diabetes mellitus and periodontal diseases. J Periodontol 77:1289–1303
Center for Disease Control and Prevention, Atlanta, GA, accessed at http://www.cdc.gov/diabetes/
Ong KL, Cheung BM, Man YB et al (2006) Treatment and control of diabetes mellitus in the United States National Health and Nutrition Examination Survey, 1999–2002. J Cardiometab Syndr 1:301–307
Devlin H, Garland H, Sloan P (1996) Healing of tooth extraction sockets in experimental diabetes mellitus. J Oral Maxillofac Surg 54:1087–1091
Gudbjörnsdottir S, Cederholm J, Nilsson PM, Eliasson B (2003) The National Diabetes Register in Sweden: an implementation of the St. Vincent Declaration for quality improvement in diabetes care. Diabetes Care 26:1270–1276
American Diabetes Association (2004) Screening for type 2 diabetes. Diabetes Care 27:S11–S14
Gilbert GH, Williams OD, Rindal DB, Pihlstrom DJ, Benjamin PL, Wallace MC, for The DPBRN Collaborative Group (2008) The creation and development of The Dental Practice-Based Research Network. J Am Dent Assoc 139:74–81
National Institute of Diabetes and Digestive and Kidney Diseases. (2007) National Diabetes Statistics. http://diabetes.niddk.nih.gov/dm/pubs/statistics
Paulweber B, Valensi P, Lindstrom J et al (2010) A European evidence-based guideline for the prevention of type 2 diabetes. Horm Metab Res 42:S3–S36
Wahab NN, Cowden EA, Pearce NJ, Gardner MJ, Merry H, Cox JL (2002) Is blood glucose an independent predictor of mortality in acute myocardial infarction in the thrombolytic era? J Am Coll Cardiol 40:1748–1754
Norhammar A, Tenerz A, Nilsson G et al (2002) Glucose metabolism in patients with acute myocardial infarction and no previous diagnosis of diabetes mellitus: a prospective study. Lancet 359:2140–2144
Lacherade JC, Jabre P, Bastuji-Garin S et al (2007) Failure to achieve glycemic control despite intensive insulin therapy in a medical ICU: incidence and influence on ICU mortality. Intensive Care Med 33:814–821
Ship J (2003) Diabetes and oral health: an overview. J Am Dent Assoc 134:4s–10s
The Diabetes Control and Complications Trial Research Group (1993) The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 329:977–986
UK Prospective Diabetes Study (UKPDS) Group (1998) Intensive blood-glucose control with sulphonylureas or insulin compared with conventional treatment and risk of complications in patients with type 2 diabetes (UKPDS 33). Lancet 352:837–853
Lindstrom J, Neumann A, Sheppard KE et al (2010) Take action to prevent diabetes—the IMAGE toolkit for the prevention of type 2 diabetes in Europe. Horm Metab Res 42:S37–S55
Barasch A, Safford MM, Qvist V, Palmore R, Gesko D, Gilbert GH, for The DPBRN Collaborative Group (2012) Random blood glucose testing in dental practice: a community-based feasibility study from The Dental Practice-Based Research Network. J Am Dent Assoc 143:262–269
Tabaei BP, Engelgau MM, Herman WH (2005) A multivariate logistic regression equation to screen for dysglycaemia: development and validation. Diabet Med 22:599–605
Edelman D, Edwards LJ, Olsen MK et al (2002) Screening for diabetes in an outpatient clinic population. J Gen Intern Med 17:23–28
Wannamethee SG, Perry IJ, Shaper AG (1999) Nonfasting serum glucose and insulin concentrations and the risk of stroke. Stroke 30:1780–1786
Annersten Gershater M, Pilhammar E, Alm Roijer C (2011) Documentation of diabetes care in home nursing service in a Swedish municipality: a cross-sectional study on nurses’ documentation. Scand J Caring Sci 25(2):220–226
Acknowledgments
This work was supported by National Institutes of Health grants U01-DE-16746, U19-DE-22516, and U01-DE-16747. Opinions and assertions contained herein are those of the authors and are not to be construed as necessarily representing the views of the respective organizations or the National Institutes of Health. The informed consent of all human subjects who participated in this investigation was obtained after the nature of the procedures had been explained fully. Dr. Safford was also supported by NIDDK P60-DK-079626.
Author information
Authors and Affiliations
Consortia
Corresponding author
Additional information
The DPBRN Collaborative Group includes practitioner–investigators, faculty investigators, and staff investigators who contributed to this DPBRN activity. A list is at www.dpbrn.org/users/publications/Default.aspx.
Rights and permissions
About this article
Cite this article
Barasch, A., Gilbert, G.H., Spurlock, N. et al. Random plasma glucose values measured in community dental practices: findings from The Dental Practice-Based Research Network. Clin Oral Invest 17, 1383–1388 (2013). https://doi.org/10.1007/s00784-012-0825-y
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00784-012-0825-y