Genco Robert J, Schifferle Robert E, Dunford Robert G, Falkner Karen L, Hsu William C, Balukjian James
Dr. Genco is a SUNY distinguished professor and vice provost, State University of New York at Buffalo, Baird Research Park, Suite 103, 1576 Sweet Home Road, Amherst, N.Y. 14228,
J Am Dent Assoc. 2014 Jan;145(1):57-64. doi: 10.14219/jada.2013.7.
In this field trial, the authors assess the feasibility of screening for diabetes and prediabetes in dental practices and in a community health center.
Dental patients 45 years and older who were not aware of their diabetic status underwent evaluation for diabetes risk with an American Diabetes Association Diabetes Risk Test and with hemoglobin (Hb) A1c measurement. Participants with an HbA1c level of 5.7 percent or greater were referred to their physicians for diagnosis.
Of the 1,022 patients screened, 416 (40.7 percent) had an HbA1c blood level of 5.7 percent or greater and were referred for diagnosis. The HbA1c and the American Diabetes Association Diabetes Risk Test were correlated (P < .001). Of the 416 participants who were referred, 35.1 percent received a diagnosis from their physicians within one year; 78.8 percent of these patients were seen in the community health center and 21.4 percent were seen in private dental offices. The diagnoses were diabetes (12.3 percent of patients), high risk of developing diabetes (that is, prediabetes) (23.3 percent) and no diabetes (64.4 percent).
The study results show that screening for prediabetes and diabetes is feasible in a dental office, with acceptance by the dentist and dental office staff members, patients' physicians and patients. Patients from the community health center demonstrated good compliance with referrals to physicians; however, compliance was poor among those in the private dental offices.
Screening for diabetes and prediabetes in the dental office may provide an important benefit to patients and encourage interprofessional collaboration to achieve a chronic care model in which health care professionals work together to care for a panel of patients.
在这项现场试验中，作者评估了在牙科诊所和社区健康中心筛查糖尿病及糖尿病前期的可行性。
45岁及以上且不知自己糖尿病状况的牙科患者接受了美国糖尿病协会糖尿病风险测试及糖化血红蛋白（Hb）A1c测量以评估糖尿病风险。HbA1c水平达到或超过5.7%的参与者被转介给其医生进行诊断。
在接受筛查的1022名患者中，416名（40.7%）HbA1c血液水平达到或超过5.7%并被转介进行诊断。HbA1c与美国糖尿病协会糖尿病风险测试具有相关性（P <.001）。在被转介的416名参与者中，35.1%在一年内从其医生处获得了诊断；这些患者中78.8%在社区健康中心就诊，21.4%在私人牙科诊所就诊。诊断结果为糖尿病（占患者的12.3%）、糖尿病高风险（即糖尿病前期）（23.3%）和无糖尿病（64.4%）。
研究结果表明，在牙科诊所筛查糖尿病前期和糖尿病是可行的，得到了牙医、牙科诊所工作人员、患者的医生及患者的认可。社区健康中心的患者对转介给医生的建议依从性良好；然而，私人牙科诊所的患者依从性较差。
在牙科诊所筛查糖尿病和糖尿病前期可能会给患者带来重要益处，并鼓励跨专业合作以实现一种长期护理模式，即医护专业人员共同为一组患者提供护理。
