Comparison Of Point-Of-Care Testing And Hospital-Based Methods In Screening For Potential Type 2 Diabetes Mellitus And Abnormal Glucose Regulation In A Dental Setting

This study aimed to compare the screening methods between point-of-care (POC) testing and hospital-based methods for potential type 2 DM and abnormal glucose regulation (AGR) in a dental setting. A total of 274 consecutive subjects who attended the Faculty of Dentistry, Mahidol University, Bangkok, Thailand, were selected. Demographic data were collected. HbA(1c) was assessed using a finger prick blood sample and analyzed with a point-of-care (POC) testing machine (DCA Vantage(R)). Hyperglycemia was defined as POC HbA(1c) >= 5.7%. Random blood glucose (RBG) was also evaluated using a glucometer (OneTouch(R) SelectSimple (TM)) and hyperglycemia was defined as RBG >= 110 mg/dl or >= 140 mg/dl. The subjects were then sent for laboratory measurements for fasting plasma glucose (FPG) and HbA(1c). The prevalence of AGR (defined as FPG >= 100 mg/dl or laboratory HbA(1c) >= 5.7%) and potential type 2 DM (defined as FPG >= 126 mg/dl or laboratory HbA(1c) >= 6.5%) among subjects was calculated and receiver operating characteristic (ROC) analysis was performed using FPG and HbA(1c) for the diagnosis of AGR and potential type 2 DM. The prevalence of hyperglycemia defined as POC HbA(1c) >= 5.7%, RBG >= 110 mg/dl, and RBG >= 140 mg/dl was 49%, 63%, and 32%, respectively. After the evaluation using laboratory measurements, the prevalence of AGR was 25% and 17% using laboratory FPG and HbA(1c) criteria, respectively. Based on the ROC curves, the performances of POC HbA(1c) and RBG in predicting FPG-defined potential type 2 DM were high (AUC = 0.99; 95% CI 0.98-0.99 and AUC = 0.94; 95% CI 0.86-1.0, respectively) but lower in predicting AGR (AUC = 0.72; 95% CI 0.67-0.78 and AUC = 0.65; 95% CI 0.59-0.70, respectively). This study suggested that POC testing might be a potential tool for screening of subjects with potential type 2 DM in a dental setting.