Screening for diabetes among periodontitis patients (CODAPT-My© ): care pathway for bridging primary care with dental care services in Malaysia

Background The practice of referring diabetic patients for dental intervention has been poor despite awareness and knowledge on the systemic effects of periodontal disease. Similarly, dentists are rarely updated on the glycaemic status of patients receiving treatment for diabetes. The rising incidence of diabetes among individuals who are unaware of their glycaemic status warrants screening among those presenting with complications of diabetes i.e. periodontitis. Objectives This study aimed to provide a standardised care pathway which will initiate screening for diabetes from dental clinics and link patients with primary care to receive optimised care for glycaemic control. Methods Modified Delphi technique was employed to obtain consensus on recommendations, based on current evidence and best care practices to screen for diabetes among patients attending dental clinics for periodontitis. Expert panel members were recruited using snowball technique and comprised of Family Medicine Specialists (5), Periodontologists (6), Endocrinologists (3) and Clinical Pharmacists (4) who are involved in management of patients with diabetes at public and private healthcare facilities. Care algorithms were designed based on existing public healthcare services. Results CODAPT© panel recommended referral to primary care for further evaluation of glycaemic status if patients diagnosed with periodontitis record fasting capillary blood glucose levels ≥ 5.6 mmol/L. Intervention treatment options for prediabetes are listed, and emphasis on feedback to dental healthcare team is outlined specifically. Conclusion CODAPT© care pathway has potential to link dental clinics with primary care to diagnose and/or optimise treatment of prediabetes/diabetes among patients receiving periodontitis treatment