One in three people who have a routine test during dental appointments are diagnosed with pre-diabetes or diabetes.
A new King’s College London study has revealed how a simple chairside test helps to screen patients who have other risk factors for the condition, such as high BMI and gum disease. The research addresses the large overlap between gum disease and diabetes.
Diabetes and pre-diabetes are steadily increasing worldwide every year. According to Diabetes UK, nearly 1.3 million people could be living with type 2 diabetes in the UK without being diagnosed. Screening and early detection are vital to reduce complications of the condition and related cost to the NHS.
In the study, a simple finger-prick blood test revealed more than 35% of patients who did not report any history of diabetes had higher than usual blood sugar levels consistent with pre-diabetes or diabetes.
Co-author Dr Giuseppe Mainas, specialist periodontist and research associate at King’s College London, said: “The findings suggest that dental visits may offer a valuable opportunity to identify those at risk of diabetes, particularly in older patients, those with higher BMI, and people with gum disease.”
The testing machine which can be used during dental appointments
Results of the HbA1c test, which measures glucose levels in the blood, are ready in as little as six minutes – reducing the need for lengthy lab testing and reducing pressures on the NHS.
HbA1c is a measure of how much glucose is bound to haemoglobin in the body, which is higher when blood sugar levels have been too high over time. The test gives an indication of average glucose levels over three months, unlike other diabetic tests which require patients to fast and only indicate glucose levels at that one moment in time.
Higher HbA1c levels were observed in patients with more severe gum disease – this was gradual and correlated, providing further evidence of the link between gum disease and metabolic health.
First author Professor Mark Ide, professor of periodontology at King’s College London, added: “When the test reveals high levels of HbA1c, patients can then see their GP to investigate further. This is something they might not have done without having the dental screening. Most of the patients in our study were surprised that they had elevated HbA1c levels and had no idea they might have pre-diabetes or diabetes.
“The other benefit of the HbA1c test is not having to fast, which could increase risk of fainting in the dental chair.”
The research is the largest UK study to date using this test during routine dental appointments at Guy's and St Thomas' NHS Foundation Trust, with a cohort of 911 patients participating in an Oral, Dental and Craniofacial Biobank at King’s College London.
The study builds on longstanding research into oral and metabolic health at King’s, with Dr Mainas co-leading a discovery last year showing that a Mediterranean diet helps to reduce gum disease last year. Another recent King’s study revealed how successful root canal treatment can help to reduce diabetes and cardiovascular risk .
Senior author Professor Luigi Nibali, Academic Lead and Director of the periodontology department at King’s College London, said: “The relationship between gum disease and metabolic health is bidirectional since impacts one another, as widely established by previous research. The inflammatory process can change the metabolic system, and the metabolic system impacts inflammation further. Gum disease can lead to complications of diabetes, and visa-versa.”
For future research, the team aims to explore the use of the test around the UK and in broader healthcare settings. “We would also like to investigate how other lifestyle factors, such as diet, affect HbA1c and gum disease”, concluded Dr Mainas.
Read the study published in the Journal of Dentistry : https://www.sciencedirect.com/science/article/pii/S0300571226002368
Journal of Dentistry