Identification of unrecognized diabetes and pre-diabetes in a dental setting.
Identifieur interne : 000320 ( Main/Exploration ); précédent : 000319; suivant : 000321Identification of unrecognized diabetes and pre-diabetes in a dental setting.
Auteurs : E. Lalla [États-Unis] ; C. Kunzel ; S. Burkett ; B. Cheng ; I B LamsterSource :
- Journal of dental research [ 1544-0591 ] ; 2011.
Descripteurs français
- KwdFr :
- Adulte (MeSH), Adulte d'âge moyen (MeSH), Aire sous la courbe (MeSH), Autorapport (MeSH), Diabète de type 2 (complications), Diabète de type 2 (diagnostic), Diabète de type 2 (sang), Femelle (MeSH), Glycémie (analyse), Humains (MeSH), Hémoglobine A glycosylée (analyse), Loi du khi-deux (MeSH), Modèles de pratique odontologique (MeSH), Modèles logistiques (MeSH), Mâle (MeSH), Perte dentaire (étiologie), Poche parodontale (étiologie), Sensibilité et spécificité (MeSH), Systèmes automatisés lit malade (MeSH), État prédiabétique (diagnostic), État prédiabétique (sang), Études prospectives (MeSH).
- MESH :
- analyse : Glycémie, Hémoglobine A glycosylée.
- diagnostic : Diabète de type 2, État prédiabétique.
- sang : Diabète de type 2, État prédiabétique.
- étiologie : Perte dentaire, Poche parodontale.
- Adulte, Adulte d'âge moyen, Aire sous la courbe, Autorapport, Femelle, Humains, Loi du khi-deux, Modèles de pratique odontologique, Modèles logistiques, Mâle, Sensibilité et spécificité, Systèmes automatisés lit malade, Études prospectives.
English descriptors
- KwdEn :
- Adult (MeSH), Area Under Curve (MeSH), Blood Glucose (analysis), Chi-Square Distribution (MeSH), Diabetes Mellitus, Type 2 (blood), Diabetes Mellitus, Type 2 (complications), Diabetes Mellitus, Type 2 (diagnosis), Female (MeSH), Glycated Hemoglobin A (analysis), Humans (MeSH), Logistic Models (MeSH), Male (MeSH), Middle Aged (MeSH), Periodontal Pocket (etiology), Point-of-Care Systems (MeSH), Practice Patterns, Dentists' (MeSH), Prediabetic State (blood), Prediabetic State (diagnosis), Prospective Studies (MeSH), Self Report (MeSH), Sensitivity and Specificity (MeSH), Tooth Loss (etiology).
- MESH :
- chemical , analysis : Blood Glucose, Glycated Hemoglobin A.
- blood : Diabetes Mellitus, Type 2, Prediabetic State.
- complications : Diabetes Mellitus, Type 2.
- diagnosis : Diabetes Mellitus, Type 2, Prediabetic State.
- etiology : Periodontal Pocket, Tooth Loss.
- Adult, Area Under Curve, Chi-Square Distribution, Female, Humans, Logistic Models, Male, Middle Aged, Point-of-Care Systems, Practice Patterns, Dentists', Prospective Studies, Self Report, Sensitivity and Specificity.
Abstract
Many diabetic patients remain undiagnosed, and oral findings may offer an unrealized opportunity for the identification of affected individuals unaware of their condition. We recruited 601 individuals who presented for care at a dental clinic, were ≥40 years old, if non-Hispanic white, and ≥30 years old, if Hispanic or non-white, and had never been told they have pre-diabetes or diabetes. Those with at least one self-reported diabetes risk factor (N=535) received a periodontal examination and a point-of-care hemoglobin A1c (HbA1c) test. A fasting plasma glucose (FPG) test was used as the study outcome, signifying potential diabetes or pre-diabetes. Performance characteristics of simple models of dysglycemia (FPG≥100 mg/dL) identification were evaluated and optimal cut-offs identified. A model including only two dental variables had an estimated area under the receiver operating characteristic curve (AUC) of 0.65. The addition of a point-of-care HbA1c test improved the AUC to 0.79 (p<0.001). The presence of ≥26% deep pockets or ≥4 missing teeth correctly identified 73% of true cases; the addition of an HbA1c≥5.7% increased correct identification to 92%. Analysis of our data suggests that oral healthcare professionals have the opportunity to identify unrecognized diabetes and pre-diabetes in dental patients and refer them to a physician for further evaluation and care.
DOI: 10.1177/0022034511407069
PubMed: 21531917
Affiliations:
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Lalla</name><affiliation wicri:level="4"><nlm:affiliation>Division of Periodontics, Section of Oral and Diagnostic Sciences, College of Dental Medicine, Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY 10032, USA. EL94@columbia.edu</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Division of Periodontics, Section of Oral and Diagnostic Sciences, College of Dental Medicine, Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY 10032</wicri:regionArea><placeName><region type="state">État de New York</region><settlement type="city">New York</settlement></placeName><orgName type="university">Université Columbia</orgName></affiliation></author><author><name sortKey="Kunzel, C" sort="Kunzel, C" uniqKey="Kunzel C" first="C" last="Kunzel">C. Kunzel</name></author><author><name sortKey="Burkett, S" sort="Burkett, S" uniqKey="Burkett S" first="S" last="Burkett">S. 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We recruited 601 individuals who presented for care at a dental clinic, were ≥40 years old, if non-Hispanic white, and ≥30 years old, if Hispanic or non-white, and had never been told they have pre-diabetes or diabetes. Those with at least one self-reported diabetes risk factor (N=535) received a periodontal examination and a point-of-care hemoglobin A1c (HbA1c) test. A fasting plasma glucose (FPG) test was used as the study outcome, signifying potential diabetes or pre-diabetes. Performance characteristics of simple models of dysglycemia (FPG≥100 mg/dL) identification were evaluated and optimal cut-offs identified. A model including only two dental variables had an estimated area under the receiver operating characteristic curve (AUC) of 0.65. The addition of a point-of-care HbA1c test improved the AUC to 0.79 (p<0.001). The presence of ≥26% deep pockets or ≥4 missing teeth correctly identified 73% of true cases; the addition of an HbA1c≥5.7% increased correct identification to 92%. Analysis of our data suggests that oral healthcare professionals have the opportunity to identify unrecognized diabetes and pre-diabetes in dental patients and refer them to a physician for further evaluation and care.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">21531917</PMID><DateCompleted><Year>2011</Year><Month>08</Month><Day>22</Day></DateCompleted><DateRevised><Year>2017</Year><Month>11</Month><Day>16</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1544-0591</ISSN><JournalIssue CitedMedium="Internet"><Volume>90</Volume><Issue>7</Issue><PubDate><Year>2011</Year><Month>Jul</Month></PubDate></JournalIssue><Title>Journal of dental research</Title><ISOAbbreviation>J Dent Res</ISOAbbreviation></Journal><ArticleTitle>Identification of unrecognized diabetes and pre-diabetes in a dental setting.</ArticleTitle><Pagination><MedlinePgn>855-60</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1177/0022034511407069</ELocationID><Abstract><AbstractText>Many diabetic patients remain undiagnosed, and oral findings may offer an unrealized opportunity for the identification of affected individuals unaware of their condition. We recruited 601 individuals who presented for care at a dental clinic, were ≥40 years old, if non-Hispanic white, and ≥30 years old, if Hispanic or non-white, and had never been told they have pre-diabetes or diabetes. Those with at least one self-reported diabetes risk factor (N=535) received a periodontal examination and a point-of-care hemoglobin A1c (HbA1c) test. A fasting plasma glucose (FPG) test was used as the study outcome, signifying potential diabetes or pre-diabetes. Performance characteristics of simple models of dysglycemia (FPG≥100 mg/dL) identification were evaluated and optimal cut-offs identified. A model including only two dental variables had an estimated area under the receiver operating characteristic curve (AUC) of 0.65. The addition of a point-of-care HbA1c test improved the AUC to 0.79 (p<0.001). The presence of ≥26% deep pockets or ≥4 missing teeth correctly identified 73% of true cases; the addition of an HbA1c≥5.7% increased correct identification to 92%. Analysis of our data suggests that oral healthcare professionals have the opportunity to identify unrecognized diabetes and pre-diabetes in dental patients and refer them to a physician for further evaluation and care.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lalla</LastName><ForeName>E</ForeName><Initials>E</Initials><AffiliationInfo><Affiliation>Division of Periodontics, Section of Oral and Diagnostic Sciences, College of Dental Medicine, Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY 10032, USA. EL94@columbia.edu</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kunzel</LastName><ForeName>C</ForeName><Initials>C</Initials></Author><Author ValidYN="Y"><LastName>Burkett</LastName><ForeName>S</ForeName><Initials>S</Initials></Author><Author ValidYN="Y"><LastName>Cheng</LastName><ForeName>B</ForeName><Initials>B</Initials></Author><Author ValidYN="Y"><LastName>Lamster</LastName><ForeName>I B</ForeName><Initials>IB</Initials></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2011</Year><Month>04</Month><Day>29</Day></ArticleDate></Article><MedlineJournalInfo><Country>United States</Country><MedlineTA>J Dent Res</MedlineTA><NlmUniqueID>0354343</NlmUniqueID><ISSNLinking>0022-0345</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D001786">Blood Glucose</NameOfSubstance></Chemical><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D006442">Glycated Hemoglobin A</NameOfSubstance></Chemical></ChemicalList><CitationSubset>D</CitationSubset><CitationSubset>IM</CitationSubset><CommentsCorrectionsList><CommentsCorrections RefType="ErratumIn"><RefSource>J Dent Res. 2012 Jul;91(7):715</RefSource></CommentsCorrections><CommentsCorrections RefType="CommentIn"><RefSource>J Evid Based Dent Pract. 2012 Jun;12(2):99-102</RefSource><PMID Version="1">22726792</PMID></CommentsCorrections><CommentsCorrections RefType="CommentIn"><RefSource>J Evid Based Dent Pract. 2012 Sep;12(3 Suppl):12-4</RefSource><PMID Version="1">23253824</PMID></CommentsCorrections></CommentsCorrectionsList><MeshHeadingList><MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019540" MajorTopicYN="N">Area Under Curve</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D001786" MajorTopicYN="N">Blood Glucose</DescriptorName><QualifierName UI="Q000032" MajorTopicYN="N">analysis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D016009" MajorTopicYN="N">Chi-Square Distribution</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D003924" MajorTopicYN="N">Diabetes Mellitus, Type 2</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName><QualifierName UI="Q000150" MajorTopicYN="N">complications</QualifierName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006442" MajorTopicYN="N">Glycated Hemoglobin A</DescriptorName><QualifierName UI="Q000032" MajorTopicYN="N">analysis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016015" MajorTopicYN="N">Logistic Models</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D010514" MajorTopicYN="N">Periodontal Pocket</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D019095" MajorTopicYN="N">Point-of-Care Systems</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D019239" MajorTopicYN="Y">Practice Patterns, Dentists'</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011236" MajorTopicYN="N">Prediabetic State</DescriptorName><QualifierName UI="Q000097" MajorTopicYN="N">blood</QualifierName><QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011446" MajorTopicYN="N">Prospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D057566" MajorTopicYN="N">Self Report</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D012680" MajorTopicYN="N">Sensitivity and Specificity</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D016388" MajorTopicYN="N">Tooth Loss</DescriptorName><QualifierName UI="Q000209" MajorTopicYN="N">etiology</QualifierName></MeshHeading></MeshHeadingList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="entrez"><Year>2011</Year><Month>5</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2011</Year><Month>5</Month><Day>3</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="medline"><Year>2011</Year><Month>8</Month><Day>23</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate></History><PublicationStatus>ppublish</PublicationStatus><ArticleIdList><ArticleId IdType="pubmed">21531917</ArticleId><ArticleId IdType="pii">0022034511407069</ArticleId><ArticleId IdType="doi">10.1177/0022034511407069</ArticleId></ArticleIdList></PubmedData></pubmed><affiliations><list><country><li>États-Unis</li></country><region><li>État de New York</li></region><settlement><li>New York</li></settlement><orgName><li>Université Columbia</li></orgName></list><tree><noCountry><name sortKey="Burkett, S" sort="Burkett, S" uniqKey="Burkett S" first="S" last="Burkett">S. Burkett</name><name sortKey="Cheng, B" sort="Cheng, B" uniqKey="Cheng B" first="B" last="Cheng">B. Cheng</name><name sortKey="Kunzel, C" sort="Kunzel, C" uniqKey="Kunzel C" first="C" last="Kunzel">C. Kunzel</name><name sortKey="Lamster, I B" sort="Lamster, I B" uniqKey="Lamster I" first="I B" last="Lamster">I B Lamster</name></noCountry><country name="États-Unis"><region name="État de New York"><name sortKey="Lalla, E" sort="Lalla, E" uniqKey="Lalla E" first="E" last="Lalla">E. Lalla</name></region></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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