Prevalence of undiagnosed diabetes and pre-diabetes in the dental setting: A Systematic review and meta-analysis

Abstract Background With the close link between Diabetes Mellitus (DM)and periodontal disease dentists have an unrealized opportunity to make a chance discovery of a patient’s medical condition. Unlike in the medical setting, information on the Point-of-Care (PoC), opportunistic screening for DM in the dental setting is limited. To make a reliable estimate on the prevalence of undiagnosed type 2 diabetes mellitus (T2DM) and prediabetes among dental patients in the dental setting and to assist healthcare planners in making an informed decision, information on the disease frequency and strategies employed to address this issue are of paramount importance . As such, the objectives of this study is to summarize the data on the prevalence of undiagnosed T2DM and pre-diabetes amongst dental patients and further explore the effectiveness of the PoC screening and its implication for use in the dental setting. Methods A MEDLINE – PubMed, EMBASE, Web of Science and Cochrane library search was conducted with no time specification. Information on study characteristics and diagnostic parameters were retrieved for metaanalysis. All the studies were assessed for methodological quality using the QUADAS 2 tool. Proportions were presented in tables and Forrest plots. All statistical analysis was performed using the Medcalc software. Results Nine studies met the inclusion criteria. The proportion of dental patients identified to be at risk of hyperglycaemia with the PoC screening using random blood glucose, and glycated haemoglobin was 32.47% and 40.10%, whilst the estimated proportion with undiagnosed T2DM and pre-diabetes was identified as 11.23% and 47.38%. Conclusion A significant proportion of dental patient can be identified as undiagnosed T2DM and prediabetes. Targeted opportunistic screening is a feasible approach and can help reduce the prevalence of undiagnosed T2DM and pre-diabetes.