Interdisciplinary cooperation between dentists and endocrinologists for identification and management of diabetes mellitus

Background: DM mellitus (DM) leads to worsening periodontal diseases, and in turn the inflammatory diseases of maxillofacial region adversely affect the glycemic control and exacerbate the severity of DM, thereby engendering a vicious cycle that compromises the DM management in patients. Taking account of the bidirectional relationship between DM and periodontal disease, interdisciplinary examination of patients with both DM and periodontal diseases is warranted to improve the health outcomes in patients.

Aims: This study aims to evaluate the perceptions of dentists and endocrinologists on the interdisciplinary cooperation for identification and management of patients with DM.

Materials and methods: Studying patients’ knowledge about DM and their compliance in providing endocrinological recommendations, dental screening survey to identify DM’ risk and signs The research was done in 2015-2016 years using clinical survey (dental status survey), statistical analysis. 432 patients from different dental organizations and 433 doctors (371 – dentists and 62 – endocrinologists) took part in the research. The research was approved by Regional research ethics committee. The written informed consent was taken from each participant.

Results: There was insufficient interdisciplinary collaboration for identification and management of patients with diabetes, and lack of motivation among dental patients to endocrinological survey. Hence, it is important to incorporate definitive screening for risk of DM for patients with inflammatory periodontal disease and include dentists in consultation for patients with DM. The feasibility of statutory determination of collaboration between specialists in identification and management of patients with DM was found, dental lectures are necessary in DM school.

Conclusions: Our findings suggest the necessity of including dentists in the standard of medical management of patients with DM and incorporating DM screening by a questionnaire upon dental examination.

diabetes mellitus, interdisciplinary cooperation, dentistry, endocrinology, mass screening

1. NCD Risk Factor Collaboration (NCD-RisC). Worldwide trends in diabetes since 1980: a pooled analysis of 751 population-based studies with 4·4 million participants. Lancet. 2016;387(10027):1513-1530. doi: 10.1016/s0140-6736(16)00618-8

2. Дедов И.И., Шестакова М.В., Викулова О.К. Эпидемиология сахарного диабета в Российской Федерации: клинико-статистический отчет по данным Федерального регистра сахарного диабета // Сахарный диабет. — 2017. — Т. 20. — №1. — С. 13-41. [Dedov II, Shestakova MV, Vikulova OK. Epidemiology of diabetes mellitus in Russian Federation: clinical and statistical report according to the federal diabetes registry. Diabetes mellitus. 2017;20(1):13-41. (In Russ.)] doi: 10.14341/DM8664

3. Mauri-Obradors E, Estrugo-Devesa A, Jane-Salas E, et al. Oral manifestations of Diabetes Mellitus. A systematic review. Med Oral Patol Oral Cir Bucal. 2017;22(5):e586-e594. doi: 10.4317/medoral.21655

4. Шестакова М.В., Дедов И.И. Сахарный диабет в Российской Федерации: аргументы и факты // Терапевтический архив. — 2016. — Т. 88. — №10. — С. 4-8. [Shestakova MV, Dedov II. Diabetes mellitus in the Russian Federation: Arguments and facts. Ter Arkh. 2016;88(10):4-8. (In Russ.)] doi: 10.17116/terarkh201688104-8

5. Pumerantz AS, Bissett SM, Dong F, et al. Standardized screening for periodontitis as an integral part of multidisciplinary management of adults with type 2 diabetes: an observational cross-sectional study of cohorts in the USA and UK. BMJ Open Diabetes Res Care. 2017;5(1):e000413. doi: 10.1136/bmjdrc-2017-000413

6. Наумова В.Н., Маслак Е.Е. Сахарный диабет и стоматологическое здоровье: проблемы диагностики и лечения пациентов стоматологических клиник. // Практическая медицина. — 2013. — №4. — С. 10-14. [Naumova VN, Maslak EE. Diabetes mellitus and dental health: problems in diagnosis and treatment of dental clinics’ patients. Prakticheskaya meditsina. 2013;(4):10-14. (In Russ.)]

7. Рунге Р.И. Новые подходы к организации стоматологической помощи больным сахарным диабетом // Врач-аспирант. — 2013. — Т. 58. — №3.1. — C. 163-168. [Runge RI. New approaches to the organization of the dental medical care for the patients with diabetes. Vrach-aspirant. 2013;58(3.1):163-168. (In Russ.)]

8. Дедов И.И., Шестакова М.В., Майоров А.Ю., и др. Алгоритмы специализированной медицинской помощи больным сахарным диабетом. / Под ред. Дедова И.И., Шестаковой М.В., Майорова А.Ю. – 8-й выпуск // Сахарный диабет. — 2017. — Т. 20. — №1S. — C. 1-121. [Dedov II, Shestakova MV, Mayorov AY, et al. Dedov II, Shestakova MV, Mayorov AY, editors. Standards of specialized diabetes care. 8th ed. Diabetes mellitus. 2017;20(1S):1-121. (In Russ.)] doi: 10.14341/DM20171S8

9. Терапевтическая стоматология. Национальное руководство. / Под ред. Дмитриевой Л.А., Максимовского Ю.М. — М.: ГЭОТАР-Медиа; 2015. [Dmitrieva LA, Maksimovskiy YM, editors. Terapevticheskaya stomatologiya. Natsional'noe rukovodstvo. Moscow: GEOTAR-Media; 2015. (In Russ.)]

10. Седова Н.Н., Навроцкий Б.А., Волчанский М.Е., и др. Теория и практика применения качественных методов социологии в медицине // Медицинский Вестник Северного Кавказа. — 2015. — Т. 10. — №3. — С. 327-331. [Sedova NN, Navrotsky BA, Volchansky ME, et al. Theory and practice of application of qualitative sociological methods in medicine. Medical news of North Caucasus. 2015;10(3):327-331. (In Russ.)] doi: 10.14300/mnnc.2015.10078

11. Кузьмина Э.М., Кузьмина И.Н., Васина С.А., Смирнова Т.А. Стоматологическая заболеваемость населения России. Состояние твердых тканей зубов. Распространенность зубочелюстных аномалий. Потребность в протезировании. — М.: МГМСУ; 2009. [Kuz`mina EM, Kuz`mina IN, Vasina SA, Smirnova TA. Stomatologicheskaya zabolevaemost' naseleniya Rossii. Sostoyanie tverdykh tkaney zubov. Rasprostranennost' zubochelyustnykh anomaliy. Potrebnost' v protezirovanii. Moscow: MGMSU; 2009. (In Russ.)]

12. Lamster, IB. Diabetes and oral health. What's their relationship? Diabetes Self Manag. 2012;29(3):32-34.

13. Al-Habashneh R, Barghout N, Humbert L, et al. Diabetes and oral health: doctors' knowledge, perception and practices. J Eval Clin Pract. 2010;16(5):976-80. doi: 10.1111/j.1365-2753.2009.01245.x

14. Forbes K, Thomson WM, Kunzel C, et al. Management of patients with diabetes by general dentists in New Zealand. J Periodontol. 2008;79(8):1401–1408. doi: 10.1902/jop.2008.070640

15. Yuen HK, Wolf BJ, Bandyopadhyay D, et al. Oral health knowledge and behavior among adults with diabetes. Diab Res Clin Pract. 2009;86(3):239–246. doi: 10.1016/j.diabres.2009.09.010

16. Macek MD, Tomar SL. Dental care visits among dentate adults with diabetes and periodontitis. J Pub Health Dent. 2009;69(4):284–289. doi: 10.1111/j.1752-7325.2009.00136.x

17. Owens JB, Wilder RS, Southerland JH, et al. North Carolina internists' and endocrinologists' knowledge, opinions, and behaviors regarding periodontal disease and diabetes: need and opportunity for interprofessional education. J Dent Educ. 2011;75(3):329-338.

18. International Diabetes Federation. IDF Guideline on oral health for people with diabetes. Brussels: IDF; 2009.

19. American Diabetes Association. Standards of medical care in diabetes – 2017. 2. Classification and Diagnosis of Diabetes. Diabetes Care. 2017;40(Suppl 1):S11-S24. doi: 10.2337/dc17-S005

20. Дедов И.И., Шестакова М.В., Галстян Г.Р. Распространенность сахарного диабета 2 типа у взрослого населения России (исследование NATION) // Сахарный диабет. — 2016. — Т. 19. — №2. — C. 104-112. [Dedov II, Shestakova MV, Galstyan GR. The prevalence of type 2 diabetes mellitus in the adult population of Russia (NATION study). Diabetes mellitus. 2016;19(2):104-112. (In Russ.)] doi: 10.14341/DM2004116-17

21. Lalla E, Cheng B, Kunzel C, et al. Dental findings and identification of undiagnosed hyperglycemia. J Dent Res. 2013;92(10):888-892. doi: 10.1177/0022034513502791

22. Herman WH, Taylor GW, Jacobson JJ, et al. Screening for prediabetes and type 2 diabetes in dental offices. J Public Health Dent. 2015;75(3):175-182. doi: 10.1111/jphd.12082

23. Сабанов В.И., Дьяченко Т.С., Горбаткова И.В., Бердник Е.Ю. Эффективность скрининг-анкетирования по выявлению среди населения сахарного диабета II типа // Волгоградский научно-медицинский журнал. — 2010. — №4. — С. 23-26. [Sabanov VI, Djachenko TS, Gorbatkova IV, Berdnik EJ. Effectivness of screening questionnaire identifying the populations with type II diabetes. Volgogradskii nauchno-meditsinskii zhurnal. 2010;(4):23-26. (In Russ.)]

24. Сабанов А.В., Горбаткова И.В., Дьяченко Т.С., Бердник Е.Ю. Территориальный регистр сахарного диабета в Волгоградской области за 2006–2010 гг. // Волгоградский научно-медицинский журнал. — 2011. — №1. — С. 60-62. [Sabanov AV, Gorbatkova IV, Djachenko TS, Berdnik EJ. The territorial register of diabetes in the volgograd region over the years 2006-2010. Volgogradskii nauchno-meditsinskii zhurnal. 2011;(1):60-62. (In Russ.)]