Screening patients for high glycemic levels using oral blood collected during a routine dental procedure gives as accurate a reading in HbA1c as traditional finger-stick readings and can identify a large number of patients who do not know they have diabetes or who are at risk for it, new research shows.
The study was published online February 25 in the American Journal of Public Health.
"There are over eight million adults in the US who have diabetes that is not yet diagnosed," lead author Shiela Stauss, PhD, from New York University College of Nursing, New York, told Medscape Medical News.
"And while there are other places that offer diabetes screening — some churches, some ophthalmology offices, some health fairs — we thought the dental office offered a particularly good place to do this…because it is possible to collect blood from the gums, and that blood can be used for diabetes screening because it is quite accurate."
Diabetes screening at the dentist could be particularly successful because about 70% of Americans seek some kind of dental care at least once a year, a greater percentage than those who visit their primary-care provider, William Herman, MD, MPH, from the University of Michigan, Ann Arbor, told Medscape Medical News.
"Only one in about 10 people who have prediabetes knows it, and probably about one-quarter to one-third of people with diabetes are undiagnosed," Dr Herman added. "So I think whatever avenues we can use to increase awareness of diabetes and get people diagnosed and into appropriate therapy are important."
HbA1c Readings from Finger-Prick and Oral Blood Virtually Identical
The study recruited New York University College of Dentistry adult patients who volunteered and met the following criteria: they indicated that their gums bled on brushing or flossing and had been told by a healthcare provider that they had diabetes or they were at risk for diabetes according to American Diabetes Association standards.
The 408 individuals who participated all had paired HbA1c values from a finger-stick blood sample as well as a gingival crevicular blood (GCB) specimen taken from the gums while seated in the dental chair. Specimens were sent to the laboratory for HbA1c analysis.
"HbA1c values assessed with finger-stick blood and GCB were nearly identical, with a correlation of 0.991," the investigators report.
Finger-stick blood HbA1c ranged from 4.2% to 10.8%, while GCB HbA1c ranged from 4.1% to 10.9%, they add.
Approximately half of the study sample had HbA1c levels in the prediabetes or diabetes range regardless of the blood source analyzed.