Patients in the dental clinics come with various complaints and various   underlying diseases which makes the treatment procedures a little different. Management protocols for patients with different underlying health issues vary from cases to cases. Diabetes is one such disease in which proper case management is needed before performing any dental procedure. 

What is Diabetes ? 

Diabetes is caused by defects in insulin secretion or insulin action in the body which results in hyperglycemia ie. increases in blood sugar. There are basically two types of diabetes: Diabetes Mellitus and Diabetes Insipidus. 

Some occurs due to failure of the pancreas to produce Insulin required by the body and in some cases the body cells itself fail to respond properly to insulin. Diabetic patients show signs of Polyphagia , polyurea, obesity, weakness, poor wound healing etc.

Diabetes has many oral effects in the patients as well like xerostomia,burning sensation, dental caries, gingivitis and periodontitis. Thus it is advised to monitor diabetic patients very carefully while operating because it can lead to severe complications. 

How to manage Diabetic patients at your clinic ?

1. Patient with symptoms of diabetes should be directly referred to physician before the treatment. 
2. Patients who have proper findings should firstly be screened by doing sugar test and checking their sugar level . 
3. The patients who have been diagnosed with diabetes must give history of the duration and medical treatment they are receiving .
4. Dentist should know which type of diabetes he has Type 1 or 2 which can tell about the severity and control level attained. 
5. Vital signs should be monitored positively before taking any step. 
6. If the disease is controlled all the dental procedures can be performed normally without any precaution and it should be checked properly that the patient has taken the medication. 
7. If the diabetes is not controlled or sugar level is less than 70 mg/dl or more than 200mg/dl  then all the dental procedures should be postponed until the blood sugar is in control .

Pre operative methods –

1. Morning appointment should be given .
2. Patient should be advised for taking normal breakfast and their medication and insulin properly . 

At the clinic – 

1. Glucose should be prepared to avoid any hypoglycaemic period while the treatment is given. 
2. Extraction with minimal trauma should be done because poor wound healing occurs in diabetic patients. 
3. Maintain verbal conversation with the patient while the treatment. 
4. Dentists should avoid any condition which can lead to Insulin shock , a life threatening condition . If it occurs then the first thing to do before is to maintain airway breathing and circulation. Patient should be placed in a supine position.
5. If the patient is conscious then give carbohydrates like honey,sugar but if he’s unconscious then 50 ml of dextrose in 50 % of concentration or 1 mg of glucagon I/V.

Hopefully you have understood about the management protocol for diabetic patients . We would like to know and help you with any queries you have regarding this topic. So contact Today’s dental for more information. 

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