Importance and Potential of Dentists in Identifying Patients at High Risk of Diabetes

Author(s): Siddardha G. Chandrupatla*, Ranadheer Ramachandra, Satyanarayana Dantala, Krishnappa Pushpanjali , Mary Tavares.

Journal Name: Current Diabetes Reviews

Volume 15 , Issue 1 , 2019

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Abstract:

Objectives: The study was conducted to assess the utilization of medical and dental services by dental patients at two dental school hospitals and to approximate the number of patients having no known previous diagnosis of type 2 diabetes but are at high risk of acquiring it.

Methods: A cross-sectional study was conducted at two dental school hospitals in India. A 20-item questionnaire was administered as interviews among the dental patients aged 35 to 55 years. Data was collected on past dental and medical visits, medical history, family history relevant to diabetes, cardiovascular health, BMI and waist circumference (measured).

Results: A total of 413 adult patients (males 61.26%, females 38.74%) participated in the surveys. The mean age was 43.06 years. Results revealed that nearly 50% did not have a medical or a dental visit in the last 1 year, 33% had Cardiovascular Diseases (CVD). Among those who did not have medical visit in last one year 45% had BMI >25 kg, 55% had waist circumference above the normal range and 38% were at high risk of diabetes.

Conclusion: The high number of patients without a medical visit in the past year or more, as well as the high levels of diabetes risk indicators, affirms the need for dentists to perform chair-side screenings for diabetes. These results suggest the need for additional training among dental students to improve early detection and identification of high-risk patients to minimize potential morbidity due to diabetes.

Keywords: Chairside medical screening, diabetes, Indian diabetes risk score, dentists, non-communicable diseases, CVD.

[1]
Office of the Registrar General & Census Commissioner India [Internet] Census india 2011 Rural urban Distrib Popul 2011; Available from: .http://censusindia.gov.in/2011-prov-results/paper2/data_files/india/Rural_Urban_2011.pdf
[2]
Ramachandran A, Murugesan N, Mary S, Snehalatha C, Yamuna A. High prevalence of diabetes and cardiovascular risk factors associated with urbanization in India. Diabetes Care 2008; 31: 893-8.
[3]
Kaveeshwar SA, Cornwall J. The current state of diabetes mellitus in India. Australas Med J 2014; 7: 45-8.
[4]
Radha V, Mohan V. Genetic predisposition to type 2 diabetes among Asian Indians. Indian J Med Res 2007; 125: 259-74.
[5]
Wild Sarah, Roglic Gojka, Green Anders, Sicree Richard, Hilary K. Global Prevalence of Diabetes: Estimates for the year 2000 and projection for 2030. Diabetes Care 2004; 27: 1047-53.
[6]
International-Diabetes-Federation In: IDF Diabetes Atlas. 7th ed. Brussels, Belgium: International Diabetes Federation 2015.
[7]
Fowler MJ. Microvascular and macrovascular complications of diabetes. Clin Diabetes 2011; 29: 116-22.
[8]
Barrett EJ, Liu Z, Khamaisi M, et al. Diabetic microvascular disease: an endocrine society scientific statement. J Clin Endocrinol Metab 2017; 102: 4343-410.
[9]
Chawla A, Chawla R, Jaggi S. Microvasular and macrovascular complications in diabetes mellitus: Distinct or continuum? Indian J Endocrinol Metab 2016; 20: 546-51.
[10]
Schett G, Kleyer A, Perricone C, et al. Diabetes Is an Independent Predictor for Severe Osteoarthritis: Results from a longitudinal cohort study. Diabetes Care 2013; 36: 403-9.
[11]
Musumeci G, Aiello FC, Szychlinska MA, Di Rosa M, Castrogiovanni P, Mobasheri A. Osteoarthritis in the XXIst century: risk factors and behaviours that influence disease onset and progression. Int J Mol Sci 2015; 16: 6093-112.
[12]
Chisari CG,, Stagni E,, Mauro M Di, . et al Risk factors for ocular surface disorders in patients with type 2 diabetes. Acta Medica Mediterr 249-53.
[13]
Lalla E, Papapanou PN. Diabetes mellitus and periodontitis: A tale of two common interrelated diseases. Nat Rev Endocrinol 2011; 7: 738-48.
[14]
Sherwin RS, Anderson RM, Buse JB, et al. The prevention or delay of type 2 diabetes. Diabetes Care 2003; 26(Suppl. 1): S62-9.
[15]
Tuomilehto J, Lindström J, Eriksson JG, et al. Prevention of type 2 diabetes mellitus by changes in lifestyle among subjects with impaired glucose tolerance. N Engl J Med 2001; 344: 1343-50.
[16]
Association AD. The Diabetes Prevention Program. Design and methods for a clinical trial in the prevention of type 2 diabetes. Am Diabetes Assoc 1999; 22(4): 623-34.
[17]
Diabetes Prevention Program Research Group.10-year follow-up of diabetes incidence and weight loss in the Diabetes Prevention Program Outcomes Study. Lancet 2009; 374: 1677-86.
[18]
Ramachandran A, Snehalatha C, Mary S, et al. The Indian Diabetes Prevention Programme shows that lifestyle modification and metformin prevent type 2 diabetes in Asian Indian subjects with impaired glucose tolerance (IDPP-1). Diabetologia 2006; 49: 289-97.
[19]
Colberg SR, Sigal RJ, Fernhall B, et al. Exercise and type 2 diabetes: the American College of Sports Medicine and the American Diabetes Association: joint position statement. Diabetes Care 2010; 33: e147-67.
[20]
Albright A, Franz M, Hornsby G, et al. American college of sports medicine position stand. exercise and type 2 diabetes. Med Sci Sports Exerc 2000; 32: 1345-60.
[21]
Gambhir RS, Brar P, Singh G, Sofat A, Kakar H. Utilization of dental care: An Indian outlook. J Nat Sci Biol Med 2013; 4: 292-7.
[22]
Sansare K, Raghav M, Kasbe A, et al. Indian patients’ attitudes towards chairside screening in a dental setting for medical conditions. Int Dent J 2015; 65: 269-76.
[23]
Narayan KMV, Boyle JP, Thompson TJ, Gregg EW, Williamson DF. Effect of BMI on lifetime risk for diabetes in the U.S. Diabetes Care 2007; 30: 1562-6.
[24]
Feller S, Boeing H, Pischon T. Body mass index, waist circumference, and the risk of type 2 diabetes mellitus: implications for routine clinical practice. Dtsch Arztebl Int 2010; 107: 470-6.
[25]
Gujral UP, Narayan KMV, Pradeepa RG, Deepa M, Ali MK, Anjana RM, et al. Comparing type 2 diabetes, prediabetes, and their associated risk factors in Asian Indians in India and in the U.S.: The CARRS and MASALA studies. Diabetes Care 2015; 38: 1312-8.
[26]
Mokdad AH, Ford ES, Bowman BA, Dietz WH, Vinicor F, Bales VS, et al. Prevalence of obesity, diabetes, and obesity-related health risk factors, 2001. JAMA 2003; 289: 76-9.
[27]
Chan JM, Rimm EB, Colditz GA, Stampfer MJ, Willett WC. Obesity, fat distribution, and weight gain as risk factors for clinical diabetes in men. Diabetes Care 1994; 17: 961-9.
[28]
Holm N-CR, Belstrøm D, Østergaard JA, Schou S, Holmstrup P, Grauballe MB. Identification of individuals with undiagnosed diabetes and pre-diabetes in a danish cohort attending dental treatment. J Periodontol 2016; 87: 395-402.
[29]
Alberti KGMM, Zimmet P, Shaw J. International Diabetes Federation: A consensus on type 2 diabetes prevention. Diabet Med 2007; 451-63.
[30]
Beagley J, Guariguata L, Weil C, Motala AA. Global estimates of undiagnosed diabetes in adults. Diabetes Res Clin Pract 2014; 103: 150-60.
[31]
Anjana RM, Sudha V, Nair DH, et al. Diabetes in Asian Indians-How much is preventable? Ten-year follow-up of the Chennai Urban Rural Epidemiology Study (CURES-142). Diabetes Res Clin Pract 2015; 109: 253-61.
[32]
Mohan V, Deepa M, Deepa R, et al. Secular trends in the prevalence of diabetes and impaired glucose tolerance in urban South India-the Chennai Urban Rural Epidemiology Study (CURES-17). Diabetologia 2006; 49: 1175-8.
[33]
Joshi SR, Das AK, Vijay VJ, Mohan V. Challenges in diabetes care in India: Sheer numbers, lack of awareness and inadequate control. J Assoc Physicians India 2008; •••: 443-50.
[34]
International Diabetes Federation (IDF). Global Guideline for Type 2 Diabetes 2012; 9-14.
[35]
Association AD. Classification and Diagnosis of Diabetes. Diabetes Care 2017; 40: S11-24.
[36]
Steeves J, Tudor-Locke C, Murphy R, King GA, Fitzhugh EC, Harris TB. Classification of occupational activity categories using accelerometry: NHANES 2003-2004. Int J Behav Nutr Phys Act 2015; 12: 89.
[37]
Misra A, Wasir JS, Vikram NK. Waist circumference criteria for the diagnosis of abdominal obesity are not applicable uniformly to all populations and ethnic groups. Nutrition 2005; 21: 969-76.
[38]
Vikram NK, Pandey RM, Misra A, Sharma R, Rama Devi J, Khanna N. Non-obese (body mass index < 25 kg/m2) Asian Indians with normal waist circumference have high cardiovascular risk. Nutrition 2003; 19: 503-9.
[39]
Singh SP, Sikri G, Garg MK. Body mass index and obesity: Tailoring “cut-off” for an Asian Indian male population. Med journal Armed Forces India 2008; 64: 350-3.
[40]
World Health Organization. Waist Circumference and Waist-Hip Ratio: Report of a WHO Expert Consultation World Heal Organ 2008.
[41]
Mohan V, Deepa R, Deepa M, Somannavar S, Datta M. A simplified Indian Diabetes Risk Score for screening for undiagnosed diabetic subjects. J Assoc Physicians India 2005; 53: 759-63.
[42]
Herman WH, Taylor GW, Jacobson JJ, Burke R, Brown MB. Screening for prediabetes and type 2 diabetes in dental offices. J Public Health Dent 2015; 75: 175-82.
[43]
Siegel K, Abel SN, Pereyra M, Liguori T, Pollack HA, Metsch LR. Rapid HIV testing in dental practices. Am J Public Health 2012; 102: 625-32.
[44]
Greenberg BL, Glick M, Frantsve-Hawley J, Kantor ML. Dentists’ attitudes toward chairside screening for medical conditions. J Am Dent Assoc 2010; 141: 52-62.
[45]
Greenberg BL, Thomas PA, Glick M, Kantor ML. Physicians’ attitudes toward medical screening in a dental setting. J Public Health Dent 2015; 75: 225-33.
[46]
Nasseh K, Greenberg B, Vujicic M, Glick M. The effect of chairside chronic disease screenings by oral health professionals on health care costs. Am J Public Health 2014; 104: 744-50.
[47]
German Institute of Human Nutrition Institute of Human Nutrition [Internet] Available from: http://www.dife.de/drpm-database/index.php
[48]
Rathmann W, Martin S, Haastert B, et al. Performance of Screening Questionnaires and Risk Scores for Undiagnosed Diabetes. Arch Intern Med 2005; 165: 436.
[49]
Schmid R, Vollenweider P, Waeber G, Marques-Vidal P. Estimating the risk of developing type 2 diabetes: a comparison of several risk scores: the Cohorte Lausannoise study. Diabetes Care 2011; 34: 1863-8.
[50]
Mann DM, Bertoni AG, Shimbo D, et al. Comparative validity of 3 diabetes mellitus risk prediction scoring models in a multiethnic us cohort: the multi-ethnic study of Atherosclerosis. Am J Epidemiol 2010; 171: 980-8.
[51]
D’Cruz AM, Shankar Aradhya MR. Health literacy among Indian adults seeking dental care. Dent Res J 2013; 10: 20-4.


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Article Details

VOLUME: 15
ISSUE: 1
Year: 2019
Page: [67 - 73]
Pages: 7
DOI: 10.2174/1573399814666180531121921
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