title: Effectiveness of screening for diabetes mellitus in dental health care.
abstract: OBJECTIVE
  The aim of the present study was to test the effectiveness of opportunistic blood glucose screening in a cooperational framework between dental and primary health care.
  
  
  METHODS
  Altogether, 1568 subjects, age 20-75 years, with no previous history of diabetes, who came for a regular dental examination, had their non-fasting blood glucose measured with a portable blood glucose meter. Subjects with a concentration of ≥ 6.7 mmol/l (121 mg dl(-1) ) were referred to their primary healthcare centre for follow-up. The outcome, a diagnosis of diabetes mellitus, was obtained from primary healthcare centre and hospital patient records, during 3 years after screening.
  
  
  RESULTS
  Of the 155 (9.9%) subjects who screened positive, 139 (89.7%) came to their primary healthcare centre within the 3-year follow-up period and nine (5.8%) were diagnosed as having diabetes mellitus according to the World Health Organization criteria. Of the 1413 subjects who screened negative, 1137 (80.5%) came to the primary healthcare centre and eight (0.6%) were found to have diabetes mellitus. Screening sensitivity was 52.9%, specificity 90.6% and positive predictive value 5.8%. The number of subjects needed to screen to find one case of diabetes was 196. Delineating the study population to those 40- to 75-year-olds with a BMI ≥ 25 kg/m(2) , and 30-to 75-year-olds with a BMI ≥ 30 kg/m(2) , the numbers needed to screen was reduced to 96.
  
  
  CONCLUSIONS
  Cooperation between dental and primary care for high blood glucose screening and follow-up appears to be a feasible method for early diagnosis of diabetes.
authors.affiliation: Uppsala University, Department of Public Health and Caring Sciences, Family Medicine and Preventive Medicine Section, Uppsala, Sweden. sevek.engstrom@pubcare.uu.se
authors.forename: S
authors.initials: S
authors.lastname: Engström
authors.forename: C
authors.initials: C
authors.lastname: Berne
authors.forename: L
authors.initials: L
authors.lastname: Gahnberg
authors.forename: K
authors.initials: K
authors.lastname: Svärdsudd
mesh_terms: D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000378:metabolism*; D015992:Body Mass Index; D003752:Dental Health Services; D003924:Diabetes Mellitus, Type 2 / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D005215:Fasting; D005260:Female; D005951:Glucose Tolerance Test / Q000379:methods*; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D011320:Primary Health Care; D012017:Referral and Consultation; D012680:Sensitivity and Specificity; D013548:Sweden / Q000453:epidemiology
chemical_list: D001786:Blood Glucose