With “diabetes month” November well underway, now is a good time to reflect on the results of one of the diabetes research projects we have been involved in.
For more than 30 years, SUNSTAR has been promoting and supporting research into diabetes. This dedication is driven by the fact that SUNSTAR’s founder, Kunio Kaneda, suffered from diabetes and eventually passed away at a relatively young age because of a diabetic complication. Years later, Kunio’s son, Hiroo, became convinced that oral health and diabetes were in some way associated. Ever since we have been collaborating with renowned research institutions and universities to understand more about this relationship.
For example, SUNSTAR recently partnered up with the Academic Centre for Dentistry Amsterdam (ACTA). Together, we noticed that even though several international guidelines advocate to integrate oral care in diabetes care (1,2,3), the impact of those recommendations on daily practice have been rather limited, and the patient has yet to benefit. The research project we initiated together established and evaluated a “best practice model” that aimed to include oral care as part of the standard diabetes care at the general practitioner’s (GP) office.
The objective of this study was to assess whether patients with type 2 diabetes mellitus would actually benefit from this in terms of improving their quality of life. This is particularly relevant since quality of life is one of the key treatment outcomes of modern primary diabetes care (4).
Bringing the mouth back into our body is key to tackle every disease holistically. Sunstar has been investing heavily in resources, training, and research to fulfil this objective. We want to help the general public and the health influencers understand that quality of life can benefit from an integrated approach to prevention and care. The study run in collaboration with ACTA is a clear example of practical step toward this vision.
Dr Marzia Massignani, Sr Manager of Scientific Affairs at Sunstar
Twenty-four GP offices – spread across the region of Amsterdam – participated in this study, recruiting a total of 764 patients. Next, the GP offices were randomly divided into two equal groups: one half continued to provide the usual care, while the other half – the intervention group – implemented an oral care protocol into their daily routine. This oral care protocol consisted of patient education, dentist referral and providing an introduction kit containing oral care products. Preliminary results show that after one year, significantly more patients improved their quality of life in the intervention group (5).
This study translated years of fundamental and epidemiological research into the daily practice of the physician, directly benefitting the patient with diabetes. It shows that oral health should become part of the holistic approach for diabetes management
Prof. dr. Bruno Loos, principle investigator of the study
The GPs and nurse practitioners participating in the study were generally receptive to make oral care part of their daily care routine, but also indicated important barriers. As an example, they mentioned that – according to the guidelines – they are expected to be able to recognize the signs for gum disease. However, in many cases, this is not so evident, or even impossible without a thorough examination performed by a trained dentist or dental hygienist. Apparently, the medical community has a strong need for alternative screening methods to quickly assess gum health without having to inspect the mouth. With the support of Sunstar, the research group at ACTA developed an online screening tool, based on a validated questionnaire that was developed years ago by another long-time friend of Sunstar, the late Professor Bob Genco (6). This screening tool only takes a few minutes to complete, but it offers medical professionals the opportunity to accurately screen for gum disease, without having to perform an oral examination.
This could help to accelerate the referral process of the patient to the dentist for a confirmatory oral check-up, supporting an early diagnosis of gum disease. The tool is freely accessible at www.perioscreening.com.
SUNSTAR believes that by supporting research and providing scientific evidence, soon healthcare protocols will shift to a more comprehensive approach, helping both healthcare providers and patients. We will therefore continue our mission and dedicate ourselves to advancing diabetes research.
- Sanz M,
Ceriello A, Buysschaert M, Chapple I, Demmer RT, Graziani F, et al. Scientific
evidence on the links between periodontal diseases and diabetes: Consensus
report and guidelines of the joint workshop on periodontal diseases and
diabetes by the International diabetes Federation and the European Federation
of Periodontology. Diabetes Res Clin Pract. 2018;137:231-41.
Clinical Guidelines Task Force. IDF Guideline on oral health for people with
diabetes. Brussels: International Diabetes Federation. 2009.
for Disease Control and Prevention. Working together to manage diabetes: a
guide for pharmacy, podiatry, optometry, and dental professionals. Atlanta: US
Department of Health and Human Services, Public Health Service, Centers for
Disease Control and Prevention, National Center for Chronic Disease Prevention
and Health Promotion. 2014.
Diabetes Association. Standards of Medical Care in Diabetes-2019 Abridged for Primary
Care Providers. Clin. Diabetes. 2019;37(1):11-34.
- Verhulst MJ, Teeuw WJ, Gerdes VE, Loos BG.
Implementation of an oral care protocol in primary diabetes care: a pilot
cluster randomized controlled trial. Ann
Fam Med. In press
- Genco RJ, Falkner KL, Grossi S, Dunford R, Trevisan
M. Validity of self-reported measures for surveillance of periodontal disease
in two western New York population-based studies. J Periodontol.
MJ, Teeuw WJ, Bizzarro S, Muris J, Su N, Nicu EA, Nazmi K, Bikker FJ, Loos BG.
A rapid, non-invasive tool for periodontitis screening in a medical care
setting. BMC oral health. 2019 Dec 1;19(1):87.