Diabetes Classification for the Oral Health Information Suite™ (RiskCalculator™)

To calculate risk scores, PreViser uses the following standards to classify the patient’s diabetic condition. This applies to both type 1 and type 2 diabetes, and is based on the level of glycemic control. You are asked to indicate the level of diabetic control as Good, Fair, or Poor.
 

Questions to Ask the Patient

You can respond to this question properly by asking your patient the following questions:

1. What is your blood glucose (blood sugar) level? (measured with a A1C test within the last six months)
  • "Good" control is less than 6.5
  • "Fair" control is 6.5 to 7.5
  • "Poor" control is greater than 7.5

2. What is your average fasting blood sugar? (measured during the last month)
  • "Good" control is between 90 and 104
  • "Fair" control is between 105 and 130
  • "Poor" control is greater than 130
 

The PreViser RiskCalculator™ values for the diabetic are:

Measurement Good control Fair control Poor control
HbA1c (%) <6.5 6.5-7.5 >7.5
AM Fasting plasma glucose (mg/dl) 90-104 105-130 >130
 

“GHb” (also called glycated hemoglobin, glycohemoglobin, glycosylated hemoglobin, HbA1c, or HbA1) most accurately indicates the previous two to three months of glycemic control. Two glycated hemoglobin tests are available: the hemoglobin A1 (HbA1) test and the hemoglobin A1c (HbA1c) test. The A1c test is quite common, so your patient may be familiar with that term.

The American Diabetes Association recommends that the goal of therapy should be a GHb of less than 7% and that physicians should reevaluate the treatment regimen in patients with GHb values consistently greater than 8%.

Good control means getting as close to a normal (nondiabetic) blood glucose level as the individual safely can. Ideally, this means levels between 90 and 130 mg/dl before meals, and less than 180 two hours after starting a meal, with a glycated hemoglobin level less than 7 percent.

In discussing these levels with your patients, it is critical to know whether their home monitor and test strips measure results in terms of whole blood or plasma values, because the plasma glucose values are 10-15% higher than whole blood glucose values.

The PreViser Support Center offers more resources to you about the relationship between periodontal disease and diabetes, and how PreViser incorporates this in calculating a patient’s risk score. You can access more information there, including position papers published in the Journal of Periodontology, and links to online documentation from the American Diabetes Association and the American Academy of Periodontology.