The ABCs of HbA1c: A Review of In-Office Diabetes Testing for the Dental Professional

This article investigates the risks as well as signs and symptoms associated with undiagnosed diabetes mellitus, the manifestations of diabetes mellitus, and the step-by-step process for integrating HbA1c testing in the dental practice.

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A peer-reviewed article written by Katrina M. Sanders, RDH, BSDH, MEd, RF, and Elizabeth A. Sanders, DPM, DADPM, AACFAS


Diabetes mellitus is a metabolic disorder affecting an estimated 463 million people or one in 11 adults worldwide. As research unpacks the codependent relationship between diabetes mellitus and a variety of diseases of oral origin, dental providers become an integral aspect to the identification, counseling, and referral of at-risk patients. Moreover, dental professionals are now encouraged to take an active role in the early identification of diabetes through hemoglobin A1c (HbA1c) testing, which strengthens a partnership between primary care providers and dental specialties while enhancing multidisciplinary involvement in optimal patient care. This article investigates the risks as well as signs and symptoms associated with undiagnosed diabetes mellitus, the manifestations of diabetes mellitus, and the step-by-step process for integrating HbA1c testing in the dental practice.

Educational objectives

Upon completion of this course, the dental professional should be able to:

  • Understand the current scientific literature indicating implications for incidence and prevalence of diabetes mellitus and oral disease, as well as the signs and symptoms of uncontrolled diabetes mellitus in the dental patient.
  • Review the oral manifestations as well as the systemic sequelae of diabetes mellitus, while identifying the risk factors and potential shared etiologic factors associated with diabetes mellitus and oral disease.
  • Discuss the opportunities for cotherapeutic management of diabetes mellitus and associated complications including counseling strategies and guidelines for the implementation of dental services for patients with diabetes.
  • Identify the clinical provision, indications, and process for gathering hemoglobin A1c (HbA1c) point-of-service tests in the dental office while utilizing the Code on Dental Procedures and Nomenclature (CDT)-approved code.

Katrina M. Sanders, RDH, BSDH, MEd, is a clinical dental hygienist, author, and international speaker. She is the clinical liaison to Hygiene Excellence and Innovation for
AZPerio. Known as “the dental resultant,” Katrina is cofounder of the Core Group LLC, a boutique-style consulting firm focused on high-level standards, excellence, and production. She is the founder, CEO, and keynote speaker for Sanders Board Preparatory; a published author with Dentaltown and Today’s RDH; a columnist and advisory board member for Modern Hygienist; and brand ambassador for Dimensions of Dental Hygiene.

Elizabeth A. Sanders, DPM, DADPM, AACFAS, is a foot and ankle surgeon in private practice in San Juan, Puerto Rico. She completed her doctor of podiatric medicine degree at Barry University in Miami Shores, Florida. She completed a foot and ankle surgical residency at Boston University Medical Center and a two-year advanced reconstructive foot and ankle fellowship at University Hospitals Regional Hospitals in Chardon, Ohio. Her passions include trauma, foot and ankle reconstructive procedures, diabetic limb salvage reconstruction, and multidisciplinary academia.

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Course Includes

  • 12 Lessons
  • 1 Test
  • Course Certificate
  • CE credit(s): 3

    Course Type: Written

    Published Date: November 2020

    This continuing education (CE) activity was developed by Endeavor Business Media with no commercial support.

    This course was written for dentists, dental hygienists, and dental assistants, from novice to skilled.

    Educational methods: This course is a self-instructional journal and web activity.

    Provider disclosure: Endeavor Business Media neither has a leadership position nor a commercial interest in any products or services discussed or shared in this educational activity. No manufacturer or third party had any input in the development of the course content.

    Requirements for successful completion: To obtain 3 CE credits for this educational activity, you must pay the required fee, review the material, complete the course evaluation, and obtain an exam score of 70% or higher.

    CE planner disclosure: Laura Winfield, Endeavor Business Media dental group CE coordinator, neither has a leadership nor commercial interest with the products or services discussed in this educational activity. Ms. Winfield can be reached at

    Educational disclaimer: Completing a single continuing education course does not provide enough information to result in the participant being an expert in the field related to the course topic. It is a combination of many educational courses and clinical experience that allows the participant to develop skills and expertise.

    Image authenticity statement: The images in this educational activity have not been altered.

    Scientific integrity statement: Information shared in this CE course is developed from clinical research and represents the most current information available from evidence-based dentistry.

    Known benefits and limitations of the data: The information presented in this educational activity is derived from the data and information contained in the reference section.

    Registration: The cost of this CE course is $39.00 for 3 CE credits.

    Cancellation and refund policy: Any participant who is not 100% satisfied with this course can request a full refund by contacting Endeavor Business Media in writing.

    Provider information:

    Dental Board of California: Provider RP5933. Course registration number CA code: 03-5933-20005. Expires October 2023. “This course meets the Dental Board of California’s requirements for 3 units of continuing education.”


    Endeavor Business Media is a nationally approved PACE program provider for FAGD/MAGD credit.
    Approval does not imply acceptance by any regulatory authority or AGD endorsement.
    11/1/2022 to 10/31/2024.
    Provider ID# 320452
    AGD code: 730


    Endeavor Business Media is designated as an approved Provider by the American Academy of Dental Hygiene, Inc. #AADHPNW (January 1, 2022–December 31, 2024). Approval does not imply acceptance by a state or provincial Board of Dentistry. Licensee should maintain this document in the event of an audit. AADH code:


    Endeavor Business Media is an ADA CERP–recognized provider.

    ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of dental continuing education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry.

    Concerns or complaints about a CE provider may be directed to the provider or to CERP at



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