2022: Screening for Diabetes in the Oral Health Care Setting: Developing a Predictive Algorithm to Identify High-Risk Patients

Approximately 2.5% of individuals with diabetes mellitus (DM) are undiagnosed. DM and periodontal disease (PD) have a suggested bidirectional relationship; those with PD have an increased risk of DM and vice versa. The goal of this study was to develop and test a predictive algorithm to identify adults at risk for DM and test their A1C levels in the dental setting.

CareQuest Institute for Oral Health developed a predictive algorithm using demographics, medical and dental history to identify patients at high risk of, but not previously diagnosed with DM. Across five health centers, patients were approached to have their A1C levels tested (finger stick) during their dental appointment, primarily by dental hygienists. Patients with prediabetes (A1C = 5.7% - 6.4%) or DM (A1C > 6.5%) were referred for follow-up medical care. Patients also completed surveys about their screening experience.

Principal findings include:

• The predictive model was able to identify 6% of patients with previously undiagnosed DM, more than twice the estimate of undiagnosed DM in the general population.
• Screening for DM in a dental setting has the promise to identify those at high risk who may not otherwise receive A1C testing.