A recent study by the University of Amsterdam and published in BMJ Open Diabetes Research & Care found that patients with periodontitis were twice as likely to have undiagnosed Type 2 Diabetes as those with less severe forms of gum disease. We spoke to Dr. Michelle Simpson of Wilmington, North Carolina about this study and what it could mean for the future of diabetes diagnosis.
An estimated 422 million people suffer from the condition known as diabetes. Here in the U.S., that number hovers around 29 million with another 8 million cases undiagnosed. Unfortunately, those numbers appear to be growing. In fact, it’s estimated that 37 percent of Americans over the age of 20 are already pre-diabetic, a condition that if not corrected will inevitably lead to full-blown diabetes. Type 2 diabetes is a metabolic disorder categorized by the body’s inability to process blood glucose properly. It causes blood glucose (or blood sugar) levels to rise to a state called hyperglycemia, making the body resistant to insulin and causing the pancreas to make extra insulin at first, and not enough insulin as the disease progresses. Patients with diabetes have shorter life spans, and frequently suffer from a host of other complications including increased risk of heart disease, lower-limb amputations, blindness, dementia, sexual dysfunction and kidney failure.
The University of Amsterdam study used glycated hemoglobin (HbA1c) stick tests to evaluate the blood of 313 patients. Shockingly, researchers found that the higher the patient’s HbA1c, the more frequent and severe the patient’s periodontitis. Furthermore, nearly 50 perecent of those patients with some stage of periodontitis were at a minimum pre-diabetic.
So, what does this mean for your next dental exam? Should your dentist be testing you for diabetes during routine checkups? Simpson thinks this type of testing may be next on the horizon
"While I doubt most dentists are trained in endocrinology, there seems to be a push for this type of testing at dental exams," she said. "It probably wouldn’t be done for all patients, but if a dentist treats a patient with advanced gum disease, and that patient meets other risk factors for diabetes such as obesity or high BMI, then diagnosis at a dental clinic could be a logical next step."
It’s a move that makes sense, especially with so many people with undiagnosed diabetes and pre-diabetes out there.
"Patients may not even realize there’s a problem, so they’re not going to ask to be tested by a physician," Simpson said. "If you’re already at a dental exam and your dentist diagnoses you with periodontitis, that’s a pretty perfect opportunity for the dentist to say ‘let’s give you an HbA1c test while you’re here’ and try to rule diabetes out. A dentist can’t treat a patient for diabetes, but we can refer them to an endocrinologist and potentially save their life."
While diabetes testing is not yet common practice at American dental clinics, it could be in the near future, especially with an aging population and increasing diabetes rates around the country.
"Dentists would need to receive additional training to conduct this type of testing in their office," Simpson said. "But with such a strong connection between the two conditions, it seems like an inevitable step."