Blood from periodontal disease can be used to screen for diabetes

Hemoglobin A1c is widely used to test for diabetes. According to guidelines established by the American Diabetes Association, an A1c reading of 6.5 or more indicates a value in the diabetes range.

The NYU researchers compared hemoglobin A1c levels in paired samples of oral and finger-stick blood taken from 75 patients with periodontal disease at the NYU College of Dentistry. A reading of 6.3 or greater in the oral sample corresponded to a finger stick reading of 6.5 in identifying the diabetes range, with minimal false positive and false negative results. The findings were published in November 2011 in the Journal of Periodontology.

"In light of these findings, the dental visit could be a useful opportunity to conduct an initial diabetes screening -- an important first step in identifying those patients who need further testing to determine their diabetes status," said the study's principal investigator, Dr. Shiela Strauss, associate professor of nursing and co-director of the Statistics and Data Management Core for NYU's Colleges of Nursing and Dentistry.

Dr. Strauss added that some patients may find the oral blood sampling in a dentist's office to be less invasive than finger stick sampling.

The one-year study utilized a version of a hemoglobin A1c testing kit that was initially developed specifically to enable dentists and dental hygienists to collect finger-stick blood samples and send them to a laboratory for analysis. The testing kit was adapted to enable analysis of both oral blood and finger-stick samples. Dr. Strauss points out that the hemoglobin A1c testing method requires only a single drop of blood to be collected, applied to a special blood collection card, and mailed to the laboratory when dry.

"There is an urgent need to increase opportunities for diabetes screening and early diabetes detection," Dr. Strauss added. "The issue of undiagnosed diabetes is especially critical because early treatment and secondary prevention efforts may help to prevent or delay the long-term complications of diabetes that are responsible for reduced quality of life and increased levels of mortality risk."

The research is part of a series of NYU nursing-dental studies examining the feasibility of screening for diabetes and other physical illnesses in the dental setting.

Dr. Strauss plans additional research on oral blood hemoglobin A1c testing involving a broader pool of subjects and dental practice sites.

Co-investigators on the study included Ms. Janet Tuthill, clinical assistant professor of dental hygiene at NYU College of Dentistry; Dr. David Rindskopf, professor of educational psychology at the Graduate School and University Center of the City University of New York, Dr. Jack A. Maggiore, president of Healthy Life Laboratories; Dr. Robert S. Schoor, clinical associate professor of periodontology and implant dentistry at the NYU College of Dentistry; Dr. Stefanie Russell, clinical assistant professor of epidemiology and health promotion at the NYU College of Dentistry; and Dr. Mary Rosedale, assistant professor of nursing at the NYU College of Nursing.

Dr. Strauss's study is dedicated to the memory of the late Alla Wheeler, Clinical Assistant Professor of Dental Hygiene, who played a major role in an earlier NYU nursing-dental study on the link between diabetes and periodontal disease.

The NYU Clinical and Translational Science Institute is a partnership between New York University's Langone Medical Center and the New York City Health and Hospitals Corporation funded by a grant from the National Center for Research Resources of the NIH.