Cultura

Early Detection Of Diabetes-Related Oral Complications: An Integrated Nursing–Radiology–Dentistry Framework

VOLUME 21, 2024

The Role of Targeted Infra-popliteal Endovascular Angioplasty to Treat Diabetic Foot Ulcers Using the Angiosome Model: A Systematic Review

VOLUME 6, 2023

Muteb Mohammed Alharbi, Mana Abdullah Almansour, Saleh Ali Alabbs, Shamah Mohammed Asiri, Rahaf Abdu Alzobide
Nourah Mohammed Alqadi, Wejdan Abdullah Alqahtani, Sayghah Salman Alanzi, Rahaf Salman Alanzi, Mishary Masood Al-Otaibi

Abstract

Diabetes mellitus is strongly associated with a range of oral complications, including periodontal disease, alveolar bone loss, impaired healing, xerostomia, and opportunistic infections. Early detection of these conditions is essential for preventing advanced oral pathology and improving systemic metabolic outcomes. This integrative review synthesizes interdisciplinary evidence published between 2010 and 2023 to explore how nursing, radiology, and dentistry contribute to the early identification of diabetes-related oral complications. A comprehensive search of PubMed, MEDLINE, CINAHL, JADA archives, and Scopus was conducted, and studies were narratively analyzed to extract thematic patterns across the three disciplines.

Findings highlight the critical role of nursing in early symptom recognition, patient education, and referral initiation; the diagnostic value of radiologic imaging, particularly cone-beam computed tomography, in detecting subtle periodontal and osseous changes; and the central role of dentistry in clinical diagnosis and management of early manifestations. Despite strong evidence supporting the oral–systemic connection, care pathways remain fragmented, leading to missed opportunities for prevention and early intervention. The review proposes an integrated interdisciplinary framework that unites nursing-led screening, radiologic evaluation, and dental diagnostic expertise to enhance early detection and improve oral-systemic health outcomes for diabetic patients.

Overall, the evidence supports the need for structured interprofessional protocols, improved communication pathways, and enhanced training across healthcare disciplines. Implementing coordinated models of care may reduce diagnostic delays, strengthen preventive strategies, and contribute to better glycemic control and overall patient wellbeing.

Keywords : Diabetes mellitus; early detection; oral complications; periodontal disease; cone-beam computed tomography (CBCT); nursing assessment; dental radiology; interdisciplinary care; oral–systemic health; integrated framework..
Erin Saricilar
Lecture in accounting. University of Basrah, College of Administration and Economics, Department of Accounting.

Abstract

Atherosclerotic disease significantly impacts patients with type 2 diabetes, who often present with recalcitrant peripheral ulcers. The angiosome model of the foot presents an opportunity to perform direct angiosome-targeted endovascular interventions to maximise both wound healing and limb salvage. A systematic review was performed, with 17 studies included in the final review. Below-the-knee endovascular interventions present significant technical challenges, with technical success depending on the length of lesion being treated and the number of angiosomes that require treatment. Wound healing was significantly improved with direct angiosome-targeted angioplasty, as was limb salvage, with a significant increase in survival without major amputation. Indirect angioplasty, where the intervention is applied to collateral vessels to the angiosomes, yielded similar results to direct angiosome-targeted angioplasty. Applying the angiosome model of the foot in direct angiosome-targeted angioplasty improves outcomes for patients with recalcitrant diabetic foot ulcers in terms of primary wound healing, mean time for complete wound healing and major amputation-free survival.
Keywords : Diabetic foot ulcer, angiosome, angioplasty