Dental Care For The Diabetic Patient
Dental Care For The Diabetic Patient
Margaret J. Fehrenbach
The Peventive Angel
Overview of Diabetes
Diabetes mellitus (DM) is a complex group of
endocrine diseases. DM is a chronic disease with no
cure.1 There are now more than 18.2 million people
with DM (around 6.3% of population). It is
estimated that a third are undiagnosed and it
remains the 4th leading cause of death. The
incidence is expected to double by the year 2010.
Undiagnosed DM
DM can be present for 10-20 years before
diagnosis. Patients can present with complications
of DM at the time of diagnosis. Patients with risk
factors for DM should be screened and referred for
medical diagnosis. These risk factors include family
history, age, and obesity.
Screening for DM
Initial screening for DM can be done in a dental
office (see sidebar). These questions can appear on
the health history form or can be asked by a dental
professional. In the future, dental offices may use
gingival bleeding for screening.2
Metabolic Consequences of DM
Inadequate insulin levels or action results in
decreased carbohydrate utilization and accelerated
glucose utilization, resulting in hyperglycemia or
high blood sugar. Decreased insulin signaling also
results in increased utilization of fats,causing ketones
to build up. These metabolic consequences can lead
to other related diseases and emergency situations.
Etiology and Types of DM
DM results when one of the following conditions
occurs:insulin released from the pancreas is impaired
or insulin action at peripheral tissues is impaired.3
Insulin is the key to the use of glucose in the body
