ETEP (Etiology and Therapy of Periodontal and Peri-implant Diseases) Research Group, University Complutense of Madrid, Madrid, Spain.
Working Group "Diabetes and Periodontal Diseases" of the Spanish Society of Diabetes (SED) and the Spanish Society of Periodontology (SEPA), Madrid, Spain.
J Clin Periodontol. 2021 Mar;48(3):378-388. doi: 10.1111/jcpe.13408. Epub 2020 Dec 21.
To evaluate the efficacy of different screening protocols for undiagnosed hyperglycaemia in a Research Network of Dental Clinics coordinated by the Spanish Society of Periodontology (SEPA).
A total of 1143 patients were included in the study. Participants filled a questionnaire considering diabetes risk factors (FINDRISC) and received a periodontal screening examination. Patients with a slightly elevated score according to the Findrisc (≥7), received a point-of-care HbA1c and were eventually referred to their physician for confirmatory diagnosis. Receiver Operating Characteristic (ROC) curves were used to assess the performance of various predictive models with confirmed hyperglycaemia as outcome.
From this population, 97 (8.5%) were finally diagnosed of diabetes (n = 28; 2.5%) or prediabetes (n = 69; 6.0%). When only including the results from the FINDRISC questionnaire, the model reported an area under the curve (AUC) of 0.866 (95% confidence interval - CI [0.833; 0.900]). This model significantly improved when a basic periodontal examination (EPB Code; AUC = 0.876; 95% CI [0.845: 0.906]; p = .042) or a point-of-care HbA1c were added (AUC = 0.961; 95% CI [0.941; 0.980]; p < .001).
The tested protocol, combining the FINDRISC questionnaire and a point-of-care HbA1c, showed to be feasible when carried out in a dental clinic setting and was efficient to identify subjects with undiagnosed diabetes or prediabetes.
评估西班牙牙周病学会(SEPA)协调的牙科诊所研究网络中不同的未诊断高血糖筛查方案的疗效。
共纳入 1143 名患者。参与者填写了一份考虑糖尿病危险因素的问卷(FINDRISC)并接受了牙周筛查检查。根据 Findrisc(≥7)评分略高的患者接受即时 HbA1c 检测,并最终由医生进行确诊。使用受试者工作特征(ROC)曲线评估各种预测模型的性能,以确诊高血糖为结局。
从该人群中,最终诊断出 97 例(8.5%)糖尿病(n=28;2.5%)或糖尿病前期(n=69;6.0%)。当仅包括 FINDRISC 问卷的结果时,该模型报告的曲线下面积(AUC)为 0.866(95%置信区间 - CI [0.833;0.900])。当添加基本牙周检查(EPB 代码;AUC=0.876;95%CI [0.845:0.906];p=0.042)或即时 HbA1c 时,该模型显著改善(AUC=0.961;95%CI [0.941;0.980];p<0.001)。
在牙科诊所环境中实施时,结合 FINDRISC 问卷和即时 HbA1c 的测试方案是可行的,并且能够有效地识别未诊断的糖尿病或糖尿病前期患者。