Study finds high rate of undiagnosed diabetes in dental patients

The study found that more than a third of dental patients with no prior diagnosis showed blood glucose levels consistent with prediabetes or diabetes when tested during routine appointments. The screening used a finger prick haemoglobin A_1c (HbA_1c) test, which measures average blood glucose over two to three months. Based on a cohort of more than 900 patients in a secondary care dental setting, the King’s study highlights that a significant burden of undiagnosed metabolic disease could be identified opportunistically in dental clinics.

The authors also examined whether periodontal status might help identify which dental patients are most appropriate for diabetes screening. They found that elevated HbA_1c levels were associated with increasing severity of periodontal disease, but that relationship weakened once other factors were taken into account, suggesting that periodontal severity alone may be of limited value as an independent trigger for testing.

Clinically, the implications are considerable. Dental services provide access to patients who may not routinely attend primary care, offering an alternative pathway for early detection. The chairside test delivers results within minutes and does not require fasting, making it suitable for use during standard appointments. The findings indicate that the use of rapid HbA_1c testing in this setting can provide a useful opportunity to identify previously unrecognised diabetes risk in order to enable timely referral for confirmatory diagnosis and management.

However, the researchers noted that the findings are based on a specific patient group with a high prevalence of periodontitis and that this may limit generalisability to other dental populations. Even so, the study underlines the potential for dental teams to contribute more actively to the early identification of chronic disease, supporting more integrated, preventive care.

Speaking on the significance of the study, lead author Dr Mark Ide, professor of periodontics at King’s, stated: “When the test reveals high levels of HbA_1c, patients can then see their general medical practitioner to investigate further. This is something they might not have done without having the dental screening. Most of the patients in our study were surprised that they had elevated HbA_1c levels and had no idea they might have prediabetes or diabetes.”

The importance of these findings is reinforced by recent UK research showing a lack of awareness among dental patients about the systemic link between periodontal disease and diabetes risk. In that context, the King’s study points not only to the screening potential of dental settings, but also to their possible role in improving awareness and promoting earlier medical follow-up. In that regard, the University of Birmingham’s INDICATE-2 study is now evaluating a dental care pathway in 50 high-street practices across the UK that involves diabetes risk assessment and finger prick HbA_1c testing, followed by referral where appropriate.

The article, titled “Association between HbA1c chairside values and periodontitis”, was published online in the April 2026 issue of the Journal of Dentistry.

Topics:

Tags: