Podcast
Questions and Answers
What is the primary feature of diabetes mellitus that defines it as a group of metabolic disorders?
What is the primary feature of diabetes mellitus that defines it as a group of metabolic disorders?
- Hypoglycaemia caused by defects in insulin secretion
- Glucagon deficiency causing hyperglycaemia
- Hyperglycaemia caused by defects in insulin secretion, insulin action, or both (correct)
- Autoimmune response to insulin-producing cells
Which type of diabetes is often associated with genetic risk factors and lifestyle choices?
Which type of diabetes is often associated with genetic risk factors and lifestyle choices?
- Type 2 diabetes (correct)
- Gestational diabetes
- Type 1 diabetes
- Medication-induced diabetes
What is the primary difference between Type 1 and Type 2 diabetes?
What is the primary difference between Type 1 and Type 2 diabetes?
- Presence of insulin resistance
- severity of hyperglycaemia
- Age of onset
- Autoimmune response versus lifestyle factors (correct)
Which of the following is NOT a type of diabetes?
Which of the following is NOT a type of diabetes?
What is the primary reason for the medical management of diabetes?
What is the primary reason for the medical management of diabetes?
What is the primary consequence of unmanaged diabetes on oral health?
What is the primary consequence of unmanaged diabetes on oral health?
What percentage of the Australian population was living with diabetes in 2021?
What percentage of the Australian population was living with diabetes in 2021?
Which of the following factors is associated with an increased risk of developing diabetes?
Which of the following factors is associated with an increased risk of developing diabetes?
What is the role of insulin in the body?
What is the role of insulin in the body?
What is the proportion of older Australians aged 80-84 who are living with diabetes?
What is the proportion of older Australians aged 80-84 who are living with diabetes?
What was the approximate number of deaths attributed to diabetes in 2021 in Australia?
What was the approximate number of deaths attributed to diabetes in 2021 in Australia?
What stimulates the production and release of insulin?
What stimulates the production and release of insulin?
What is the primary mechanism behind the development of atherosclerosis in diabetes mellitus?
What is the primary mechanism behind the development of atherosclerosis in diabetes mellitus?
Which of the following is a characteristic of hyperosmolar hyperglycaemic state?
Which of the following is a characteristic of hyperosmolar hyperglycaemic state?
What is the primary cause of hypoglycaemia in diabetes mellitus?
What is the primary cause of hypoglycaemia in diabetes mellitus?
Which of the following is a complication of chronic hyperglycaemia in diabetes mellitus?
Which of the following is a complication of chronic hyperglycaemia in diabetes mellitus?
What is the typical blood glucose level associated with hypoglycaemia?
What is the typical blood glucose level associated with hypoglycaemia?
What is the effect of diabetes mellitus on immune function?
What is the effect of diabetes mellitus on immune function?
What is the primary complication of chronic hyperglycaemia that affects the kidneys?
What is the primary complication of chronic hyperglycaemia that affects the kidneys?
What is the effect of chronic hyperglycaemia on Schwann cells?
What is the effect of chronic hyperglycaemia on Schwann cells?
What is the minimum fasting plasma glucose level required for a diagnosis of diabetes?
What is the minimum fasting plasma glucose level required for a diagnosis of diabetes?
What is the primary complication of chronic hyperglycaemia that affects the eyes?
What is the primary complication of chronic hyperglycaemia that affects the eyes?
What is the primary macrovascular complication of chronic hyperglycaemia?
What is the primary macrovascular complication of chronic hyperglycaemia?
What is the primary effect of chronic hyperglycaemia on renal blood flow?
What is the primary effect of chronic hyperglycaemia on renal blood flow?
What is the primary consideration for dental management of insulin-dependent diabetics?
What is the primary consideration for dental management of insulin-dependent diabetics?
What is the primary symptom of hypoglycaemia?
What is the primary symptom of hypoglycaemia?
What is the recommended treatment for a patient experiencing mild hypoglycaemia?
What is the recommended treatment for a patient experiencing mild hypoglycaemia?
What is the risk associated with SGLT2 inhibitors and surgical procedures?
What is the risk associated with SGLT2 inhibitors and surgical procedures?
What should be done to a patient experiencing severe hypoglycaemia?
What should be done to a patient experiencing severe hypoglycaemia?
Why is it important to prioritize dental treatment for poorly controlled diabetics?
Why is it important to prioritize dental treatment for poorly controlled diabetics?
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Study Notes
Definition of Diabetes Mellitus
- Diabetes mellitus (DM) is a group of metabolic disorders characterized by hyperglycaemia caused by defects in insulin secretion, insulin action, or both.
Classification of Diabetes
- Type 1: autoimmune disease; onset usually in childhood/early adulthood
- Type 2: lifestyle-associated with genetic risk factors
- Gestational diabetes: abnormal blood homeostasis during pregnancy
- Others: pancreatic disease, medication-induced (e.g., long-term corticosteroids), genetics (e.g., Down syndrome)
Epidemiology
- 1 in 20 Australians (5.1% of the total population) living with diabetes in 2021
- Older Australians aged 80-84: 1 in 5 persons
- Diabetes contributed to about 19,300 deaths in 2021
Insulin
- Glucose stimulates insulin production and release
- Insulin increases the rate of glucose transport from bloodstream into cells in the body
Complications of Diabetes
Acute Complications
- Diabetic ketoacidosis (DKA): a complication of mainly type 1 diabetes
- Hyperosmolar hyperglycaemic state (HHS): a complication of type 2 diabetes
- Hypoglycaemia: due to insulin overdose or inadequate calorific intake
Chronic Complications
- Macrovascular complications: atherosclerosis, IHD, MI, stroke, peripheral vascular disease
- Microvascular complications: nephropathy, retinopathy, peripheral and autonomous neuropathy, impaired wound healing, periodontal disease
Laboratory Markers
- Fasting Plasma Glucose (FPG): ≥126 mg/dL (≥7.0 mmol/L) on two occasions
- Non-Fasting Random Glucose: ≥200 mg/dL (11.1 mmol/L)
- Oral Glucose Tolerance Test (OGTT): 2 hours: ≥200 mg/dL
Dental Management Considerations
- Avoid medical emergencies
- Timing of dental treatment: minimize disruption to routine
- Ensure patient does not skip meals
- Invasive treatment: maintain usual caloric intake and medication regimen
- Consider checking RBG at start of appointment, especially for insulin-dependent diabetics with labile blood glucose levels
Identification and Treatment of Hypoglycaemia in the Dental Office
- Symptoms: shakiness, anxiety, palpitations, increased sweating, hunger
- Signs: tremors, tachycardia, altered consciousness, blood glucose level below 4.0 mmol/L
- Emergency management: terminate dental treatment, administer 15 g oral carbohydrate, monitor blood glucose and repeat carbohydrate dosing as necessary
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