Dental teams in the UK may help to detect the early signs of type-2 diabetes, as research aims to validate routine screening during oral health check-ups.

Diabetes is one of the most common chronic conditions in Europe and is widely recognised to have a strong link with periodontitis. An estimated one in three people are living with undiagnosed diabetes, with over one million undiagnosed in the UK alone. If left untreated, diabetes can lead to long-term health complications and can be life-threatening.

Researchers at the University of Birmingham recognised this link and secured funding from Haleon and the support of the National Institute for Health and Care Research (NIHR) Birmingham Biomedical Research Centre (BRC) to continue developing a care pathway for early case detection of type-2 diabetes and pre-diabetes in high-street dental practices.

In a study published in 2023, the group at the University of Birmingham, comprised of Zehra Yonel, Iain Chapple, and Thomas Dietrich, teamed up with Laura Gray from the University of Leicester to develop a score called the ‘Diabetes risk assessment in Dentistry Score’ (DDS). This score was to be used by dental teams to detect pre-diabetes and diabetes in dental settings.

As part of a pilot study called Indicate, funded by NIHR and Diabetes UK, the DDS was used in conjunction with a finger-prick test for diabetes, called the HbA1c test. The Indicate trial, which involved 13 dental practices and 805 dental patients, found that almost 15 per cent of people who walked through dental practice doors perceiving themselves to be healthy, exceeded UK pre-diabetes / diabetes thresholds (≥ 42mmol/mol HbA1c).

Following funding from Haleon and NIHR, an Indicate-2 trial is set to work with 50 dental practices across England and Scotland to screen more than 10,000 patients. Researchers will develop a care pathway that could help health services detect and treat people with undiagnosed diabetes in the UK.

Zehra Yonel, clinical lecturer in periodontology at the University of Birmingham’s Dental School and co-lead researcher on Indicate-2, said, “This exciting collaboration with Haleon will allow us to determine the actual prevalence of pre-diabetes and type-2 diabetes within a larger, more representative population sample and assess the feasibility of scaling this approach nationally.

“It will explore the patient journey and identify barriers or challenges in the care pathway from oral health professional to general medical practitioner (GP) and back to the dental team.”

Jason Wong, chief dental officer of NHS England, said, “It is vitally important that medical and dental care pathways become more joined up, to put patients at the centre of all we do. Indicate-2 is a great example of a study aimed to try and define one such pathway.”

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