From now on, diabetes can also be diagnosed by the oral care professional, or almost.This is what is intended with an innovative action protocol that wants to evaluate the risk of diabetes not known in patients who attend the dentist and that has been designed by the working group "Diabetes and Periodontal Disease", composed of specialists from the specialists of theSpanish Society of Periodontics (SEPA) and the Spanish Diabetes Society (SED).After being tested and validated, it is intended that it can be extended throughout Spain.
"Dental care can be an adequate ally for the fight against type 2 diabetes," this is what the president of SEPA, David Herrera, believes that "the oral care clinics, composed of a broad and varied multidisciplinary team of professionals, can be used to detect as soon as possible the risk of diabetes ”, thus contributing to fighting one of the main problems that currently subsist in the approach of this metabolic disease: late diagnosis.
The end of this project, promoted by the SEPA Foundation in collaboration with other scientific societies, is to convert the oral health professional into an active collaborator of general health promotion and early detection of systemic diseases, erecting an essential ally for other professionals for other professionalsof health.
According to a recent study in Spain (di@bet.es, prepared by cyberdem), in Spain there is a prevalence of type 2 diabetes of 13.8%, (more than 5.3 million people), with 7.8%of diagnostic diabetes (almost 3 million people), while 6% (more than 2.3 million people) would ignore their situation.Type 2 diabetes mellitus is a global epidemic that induces important complications (fundamentally cardiovascular), which cause high morbidity and mortality.
However, despite their magnitude and serious consequences, there are many people with diabetes that have not been diagnosed.This delay induces, among other consequences, greater risks for patients and higher costs for the health system."Early performance can prevent diabetes progression, and can avoid and delay the multiple chronic complications of this disease," says Juan Girbés, of thirst.
Fernando de la Torre, the Federation of Spanish Diabetics (FEDE) and the Federation of Diabetics of the Valencian Community (Fedicova), which considers that “these types of initiatives involve an impulse in the early detection of early detection of the early detection of diabetics (Fede)Diabetes since one of its main problems is late diagnosis.Thus, patients can be identified with high risk of diabetes, being able to derive them to the most appropriate healthcare professional ».
In this context, says Herrera, "oral health professionals can help detect these people with prediabetes or with non -diagnosed diabetes, in routine consultations for oral health controls, in maintenance revisions and/or in specific interventions."In fact, in recent years many and solid scientific and clinical evidence that reveals the close relationship between diabetes and periodontal diseases have been accumulated.
Girbés, explains that «diabetes and periodontal disease have a bidirectional relationship: on the one hand, diabetes increases about three times the risk of periodontitis, especially if there is bad glucemic control, and on the other hand, the existence of periodontitis negatively affectsto the glycemic control of people with diabetes and contributes to the appearance of diabetes complications ».It has even been shown that periodontal treatment leads to improve glycemic control in patients with diabetes.
patient screening Starting from this link, oral care and care can be considered to play an important role in the management of people with diabetes, opening the possibility of using in this context "screening" to identify patients with high risk of suffering from diabetes mellitus withoutdiagnose or with prediabetes.Therefore, the thirst and knows have launched an initiative to prepare and implement in the dental care mixed protocols for the risk of suffering from diabetes not known.
The project, which will initially be validated in the network of Research Clinics, currently integrated by half a hundred clinics distributed throughout Spain, is coordinated by David Herrera González, Eduardo Montero Solís, from the Complutense University of Madrid, and by José LuisHerrera Pombo, coordinator of the SEPA-SEED working group and former president of SED.
The initiative also has solid scientific evidence."We know that screening protocols for type 2 diabetes mellitus performed in the field of oral care are effective and, therefore, dental professionals can play a relevant role in the detection of non -diagnosed diabetes," says the president of SEPA.
Diagnostic capacity
In the foreseen protocol, it is based on the hypothesis that people who combine a high risk of having diabetes (evaluated by the test called Findrrisc) and a worse periodontal health (determined by the basic periodontal examination, EPB) will have more possibilities of suffering from diabetesor non -diagnosed prediabetes and, therefore, they will be candidates to become a specific review to confirm or not this suspicion.
In addition, this protocol will evaluate the diagnostic capacity of different resources, valuing its usefulness to distinguish between healthy people, with prediabetes or diabetes.Thus, the percentage of patients will be evaluated who, according to the different diagnostic strategies used, have finally been able to confirm or not a diagnosis of diabetes or prediabetes.
For the Spanish Society of Primary Care Physicians (Semergen), which supports this type of collaboration initiative between health professionals from different disciplines, there is no doubt that “it is an innovative action, which gives value to the professionals of theOral health as promoters of general health, ”says Rafael Micó, from Semergen.
The mouth is a window that allows us to appear to the general health status.Therefore, taking another step, "the close collaboration between dentists and primary care doctors or specialized care will facilitate a better handling of many other diseases," says Micó, which highlights the existence of a collaboration agreement of Semergen andKnow to promote formative and informative initiatives of this type.
