Newly Identified Dysglycemia in Dental Patients and Periodontal Parameters

Saturday, March 23, 2013

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Washington State Convention Center
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For Release March 21, 2013

 

Newly Identified Dysglycemia in Dental Patients and Periodontal Parameters
Seattle, Wash., USA – Today, at the 91st General Session & Exhibition of the International Association for Dental Research, held in conjunction with the 42nd Annual Meeting of the American Association for Dental Research and the 37th Annual Meeting of the Canadian Association for Dental Research, lead researcher Evanthia Lalla, Columbia University College of Dental Medicine, New York, USA, will present a research study titled “Newly Identified Dysglycemia in Dental Patients and Periodontal Parameters.”

Many diabetic patients remain undiagnosed. Using fasting plasma glucose to signify potential dysglycemia, the team of researchers previously reported that oral findings can contribute to the identification of affected individuals unaware of their condition. Since then, a change in guidelines introduced high-performance liquid chromatography (HPLC) hemoglobin A1c (HbA1c) as an alternative for diabetes diagnosis, but evidence suggests that HbA1c- vs. glucose-based criteria may identify different segments of the population. The aim of the current study was to assess if periodontal parameters have a role in early diabetes identification when HbA1c is used for case definition.
In this study, new dental patients who had never been told they have pre-diabetes or diabetes were recruited. To target individuals at risk for dysglycemia, the team selected those who were greater than or equal to 40 years old if non-Hispanic white, and greater than or equal to 30 years old if Hispanic or non-white and reported at least one additional diabetes risk factor: family history, hypertension, hypercholesterolemia or overweight/obesity. A periodontal examination and a screening fingerstick HbA1c were performed. An HPLC HbA1c following venipuncture was used to indicate potential diabetes or pre-diabetes. Predictive models we had singled-out for their discriminative power in our earlier study were evaluated in the present population.

Thus far, among 508 subjects examined, 295 individuals with an abnormal HPLC HbA1c were identified: 48 (9.4%) potentially diabetic (HbA1c ≥ 6.5%) and 247 (48.6%) potentially pre-diabetic (HbA1c=5.7-6.4%). Periodontal status was significantly worse in the abnormal HbA1c groups. The presence of a pocket ≥ 5mm in at least 26% of the teeth or at least 4 missing teeth correctly identified 72% of true cases with unrecognized hyperglycemia; the addition of a fingerstick HbA1c ≥ 5.7% increased correct identification to 91%. The researchers concluded that dental professionals have the unrealized capability to identify unrecognized dysglycemia in their patients and refer them to a physician for further evaluation and care.

This research was supported by Colgate-Palmolive Company and the New York State Health Foundation.
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This is a summary of abstract #341, “Newly Identified Dysglycemia in Dental Patients and Periodontal Parameters,” to be presented by Evanthia Lalla on Thursday, March 21, 2013, 8:15 a.m. – 8:30 a.m. at the Washington State Convention Center, room 303.
About the International Association for Dental Research
The International Association for Dental Research (IADR) is a nonprofit organization with nearly 12,800 individual members worldwide, dedicated to: (1) advancing research and increasing knowledge to improve oral health worldwide, (2) supporting and representing the oral health research community, and (3) facilitating the communication and application of research findings. To learn more, visit www.iadr.org.
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