Early detection of non-diabetic hyperglycaemia and type 2 diabetes in dental practice settings

Yonel, Zehra ORCID: 0000-0002-5477-8315 (2023). Early detection of non-diabetic hyperglycaemia and type 2 diabetes in dental practice settings. University of Birmingham. Ph.D.

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Abstract

Type 2 diabetes (T2D) is a highly prevalent chronic, non-communicable disease (NCD). The high morbidity, mortality, societal and economic costs associated with T2D are well documented.

Periodontitis is also a highly prevalent NCD with a well-established independent association with T2D. Periodontitis can only be diagnosed by oral healthcare professionals and it is mandatory to screen patients for periodontitis.

This thesis, comprising three main themes, to evaluate dental settings as sites for early detection of non-diabetic hyperglycaemia (NDH) and T2D aimed to:

1) determine whether new cases of NDH/T2D could be identified in dental settings. The literature was systematically reviewed to assess whether different cohorts of the population access different healthcare settings (papers 1 and 2).
2) focus on stakeholder perception of utilising oral healthcare teams to identify NDH/T2D within dental settings. The literature was systematically reviewed and a survey conducted with key-stakeholders in the UK (papers 3 and 4).
3) explore whether current risk-assessment tools were appropriate for use in dental settings. The concordance of point of care devices was evaluated and a risk assessment model and score was developed and validated (papers 5 and 6).

Key Findings

Undiagnosed cases of NDH/T2D can be identified in dental settings. Different population groups access different healthcare teams, providing a potential opportunity for oral care teams to assess those not tested elsewhere.

There is broad support from stakeholders for utilising oral care teams to risk-assess for NDH/T2D in dental settings.

A two-staged risk-assessment strategy utilising a questionnaire based risk assessment for initial stratification followed by a point-of-care capillary blood sample appears to offer the optimal approach to risk-assessment. A questionnaire utilising data routinely available to oral care teams performs at the same level as current medical questionnaires containing data dental teams would not routinely access.

Type of Work:

Thesis (Doctorates > Ph.D.)

Award Type:

Doctorates > Ph.D.

Supervisor(s):