Use of dental practices for the identification of adults with undiagnosed type 2 diabetes mellitus or non-diabetic hyperglycaemia; a systematic review

Background

Type 2 diabetes is a growing global challenge. Evidence exists demonstrating use of primary care (non-hospital based) dental practices to identify, through risk-assessments, those who may be at increased risk of type 2 diabetes or who may already unknowingly have the condition.

Aim

Synthesise the evidence associated with the use of primary-care dental services for the identification of undiagnosed non-diabetic hyperglycaemia or type 2 diabetes in adult patients, with a particular focus on the pick-up rate of new cases.

Method

Electronic databases were searched for studies reporting the identification of non-diabetic hyperglycaemia/type 2 diabetes in primary-care dental settings. Returned articles were screened and two independent reviewers completed the data extraction process. A descriptive synthesis of the included articles was undertaken due to heterogeneity of the literature returned.

Results

Nine studies were identified. The majority of studies utilised a 2-stage risk-assessment process with risk-score followed by point-of-care capillary blood test (POCT). The main barriers cited were costs, lack of adequate insurance cover and patients having previously been tested elsewhere. The pick-up rate of new cases of type 2 diabetes and non-diabetic hyperglycaemia varied greatly between studies and ranged from 1.7% to 24% for type 2 diabetes 23% to 45% for non-diabetic hyperglycaemia, where reported.

Conclusion

This review demonstrates that although it appears there may be benefit in using the dental workforce to identify undiagnosed cases of non-diabetic hyperglycaemia and type 2 diabetes, further high-quality research in the field is required assessing both the clinical-effectiveness and cost-effectiveness of such practice.