Diabetes mellitus

Question 1

Impaired insulin secretion, hyperglycaemia , younger age of onset

Answer 1

DM 1

Question 2

Insulin deficiency and insulin resistance. Older patients

Answer 2

DM 2

Question 3

Overproduction and poor utilization of insulin results in over accumulation of glucose.

Answer 3

Hyperglycemia

Question 4

Increased glucose in urine, dehydration and loss of electrolytes, nonketotic coma

Answer 4

Type 2 DM

Question 5

Patient will eat more but still may loose weight due to cellular starvation

Answer 5

Diabetes Mellitus

Question 6

DM type I medications

Answer 6

Rapid acting - Insulin aspart, insulin lispro
Short acting- regular soluble
Intermediate acting -NPH isophane, lente

Question 7

DM type II medications

Answer 7

Sulfonylureas
Metformin
Thiazolidinediones/glitazones
Alpha-glucosidase inhibitors- acarbose, miglitol
Meglitinides- repaglinide, nateglinide

Question 8

HbA1c target and optimal

Answer 8

Target- <= 7%
Optimal- <= 6%

Question 9

Fasting plasma glucose target and optimal

Answer 9

Target- 4 to 7 mmol/L
Optimal - 4-6 mmol/L

Question 10

2 h post prandial glucose

Answer 10

Target : 5-10mmol/L
Optimal: 5-8mmol/L

Question 11

Dental management special considerations for diabetes

Answer 11

Use glucometer
For pts taking sufonylureas avoid aspirin or NSAIDs

Question 12

Fasting blood glucose reading which recommends defering elective tx

Answer 12

<70 mg/dL or >200 mg/dL

Question 13

Thirst
Excessive urination
Weakness, visual disturbances
Dry skin and heat
Fruity sweet breath odour
Kussmaul’s respiration

Answer 13

Diabetic coma or hyperglycemia

Question 14

Hunger, nausea
Rapid weak pulse
Sweating, shaking
Slurred speech, pallor
Tonic clonic
Hypotension
Hypothermia- cold & sweaty

Answer 14

Hypoglycemia or insulin shock

Question 15

Hypoglycemia management

Answer 15

Conscious:
Upright
Drink with high sugar
Monitor vital signs

Unconscious:
Supine position
911
Head tilt chin lift
Oxygen
50% dextrose IV or glucagon 1mg SC or IM