Compliance with Diabetes-Periodontitis Management Guideline: A Clinical Audit in a Postgraduate Periodontology Clinic
DOI:
https://doi.org/10.24191/cos.v13i2.10575Keywords:
periodontitis, diabetes mellitus, clinical audit, guidelines, interdisciplinary, careAbstract
Background: Periodontitis and diabetes mellitus (DM) have a two-way relationship, with periodontitis exacerbating systemic complications of diabetic and poor glycaemic control contributing to progression of periodontitis. Objective: This clinical audit was conducted to evaluate the compliance of the postgraduate (PG) students with the recommended international guideline, identify practice gaps, and provide baseline evidence for developing a standardized protocol to improve the management of periodontitis patients with DM. Materials and Methods: A retrospective audit was performed on periodontitis patients with DM treated between 2018 and 2022. Data retrieved from the iDerms system, included documentation of HbA1c or glycaemic status, dietary advice, education on the periodontitis-DM relationship, and referral to medical officer (MO). Compliance was analyzed descriptively. Results: Forty-seven patients (mean age 55.2±10.3 years, range 26-74) were included in the analysis. Only 38.3% had HbA1c level documented by 56.3% of students, with the majority were recorded more than 6 months after first visit. Less than 5% of patients had documentation of dietary advice or education on the periodontitis-DM relationship. Furthermore, only 25.5% of patients were reported to have liaised with MO regarding their periodontitis-DM condition. Overall, students’ compliance with recommended standards was suboptimal. Conclusion: These findings emphasize the need to establish a structured, evidence-based protocol, improve interdisciplinary liaison with MO, and reinforce postgraduate training to ensure guideline-based care. A re-audit following implementation of these recommendations is warranted to monitor improvement and sustain quality of patient care.
References
Belting, C. M., Hiniker, J. J., & Dummett, C. O. (1964). Influence of Diabetes Mellitus on the Severity of Periodontal Disease. The Journal of Periodontology, 35(6), 476–480. https://doi.org/10.1902/jop.1964.35.6.476
Chapple, I. L. C. (2014). Time to take periodontitis seriously. BMJ, 348(apr10 1), g2645–g2645. https://doi.org/10.1136/bmj.g2645
Chapple, I. L. C., & Genco, R. (2013). Diabetes and periodontal diseases: consensus report of the Joint EFP/AAP Workshop on Periodontitis and Systemic Diseases. Journal of Periodontology, 84(4S). https://doi.org/10.1902/jop.2013.1340011
Chapple, I. L. C., Van der Weijden, F., Doerfer, C., Herrera, D., Shapira, L., Polak, D., Madianos, P., Louropoulou, A., Machtei, E., Donos, N., Greenwell, H., Van Winkelhoff, A. J., Eren Kuru, B., Arweiler, N., Teughels, W., Aimetti, M., Molina, A., Montero, E., & Graziani, F. (2015). Primary prevention of periodontitis: managing gingivitis. Journal of Clinical Periodontology, 42(S16). https://doi.org/10.1111/jcpe.12366
Chávarry, N. G. M., Vettore, M. V., Sansone, C., & Sheiham, A. (2009). The relationship between diabetes mellitus and destructive periodontal disease: a meta-analysis. Oral Health & Preventive Dentistry, 7(2), 107–127.
Lalla, E., & Papapanou, P. N. (2011). Diabetes mellitus and periodontitis: a tale of two common interrelated diseases. Nature Reviews Endocrinology, 7(12), 738–748. https://doi.org/10.1038/nrendo.2011.106
Magliano, D. J., Chen, L., Islam, R. M., Carstensen, B., Gregg, E. W., Pavkov, M. E., Andes, L. J., Balicer, R., Baviera, M., Boersma-van Dam, E., Booth, G. L., Chan, J. C. N., Chua, Y. X., Fosse-Edorh, S., Fuentes, S., Gulseth, H. L., Gurevicius, R., Ha, K. H., Hird, T. R., … Shaw, J. E. (2021). Trends in the incidence of diagnosed diabetes: a multicountry analysis of aggregate data from 22 million diagnoses in high-income and middle-income settings. The Lancet Diabetes & Endocrinology, 9(4), 203–211. https://doi.org/10.1016/S2213-8587(20)30402-2
Ogurtsova, K., da Rocha Fernandes, J. D., Huang, Y., Linnenkamp, U., Guariguata, L., Cho, N. H., Cavan, D., Shaw, J. E., & Makaroff, L. E. (2017). IDF Diabetes Atlas: Global estimates for the prevalence of diabetes for 2015 and 2040. Diabetes Research and Clinical Practice, 128, 40–50. https://doi.org/10.1016/j.diabres.2017.03.024
Papapanou, P. N., Sanz, M., Buduneli, N., Dietrich, T., Feres, M., Fine, D. H., Flemmig, T. F., Garcia, R., Giannobile, W. V., Graziani, F., Greenwell, H., Herrera, D., Kao, R. T., Kebschull, M., Kinane, D. F., Kirkwood, K. L., Kocher, T., Kornman, K. S., Kumar, P. S., … Tonetti, M. S. (2018). Periodontitis: Consensus report of workgroup 2 of the 2017 World Workshop on the Classification of Periodontal and Peri‐Implant Diseases and Conditions. Journal of Periodontology, 89(S1). https://doi.org/10.1002/JPER.17-0721
Sanz, M., Herrera, D., Kebschull, M., Chapple, I., Jepsen, S., Berglundh, T., Sculean, A., & Tonetti, M. S. (2020). Treatment of stage I–III periodontitis—The EFP S3 level clinical practice guideline. Journal of Clinical Periodontology, 47(S22), 4–60. https://doi.org/10.1111/jcpe.13290
Tonetti, M. S., Greenwell, H., & Kornman, K. S. (2018). Staging and grading of periodontitis: Framework and proposal of a new classification and case definition. Journal of Clinical Periodontology, 45(S20). https://doi.org/10.1111/jcpe.12945
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