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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?

  • Type 2 diabetes (correct)
  • Gestational diabetes
  • Type 1 diabetes
  • Medication-induced 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?

    <p>Hyperglycaemia-induced diabetes (A)</p> Signup and view all the answers

    What is the primary reason for the medical management of diabetes?

    <p>To manage the underlying causes of diabetes (A)</p> Signup and view all the answers

    What is the primary consequence of unmanaged diabetes on oral health?

    <p>Increased risk of periodontal disease (B)</p> Signup and view all the answers

    What percentage of the Australian population was living with diabetes in 2021?

    <p>5.1% (B)</p> Signup and view all the answers

    Which of the following factors is associated with an increased risk of developing diabetes?

    <p>Genetics (Down syndrome) (B)</p> Signup and view all the answers

    What is the role of insulin in the body?

    <p>To increase the rate of glucose transport from the bloodstream into cells (C)</p> Signup and view all the answers

    What is the proportion of older Australians aged 80-84 who are living with diabetes?

    <p>1 in 5 (A)</p> Signup and view all the answers

    What was the approximate number of deaths attributed to diabetes in 2021 in Australia?

    <p>19,300 (B)</p> Signup and view all the answers

    What stimulates the production and release of insulin?

    <p>Glucose (C)</p> Signup and view all the answers

    What is the primary mechanism behind the development of atherosclerosis in diabetes mellitus?

    <p>Non-enzymatic glycosylation of vascular basement membranes (B)</p> Signup and view all the answers

    Which of the following is a characteristic of hyperosmolar hyperglycaemic state?

    <p>Severe dehydration (B)</p> Signup and view all the answers

    What is the primary cause of hypoglycaemia in diabetes mellitus?

    <p>Insulin overdose (A)</p> Signup and view all the answers

    Which of the following is a complication of chronic hyperglycaemia in diabetes mellitus?

    <p>All of the above (D)</p> Signup and view all the answers

    What is the typical blood glucose level associated with hypoglycaemia?

    <p>Lower than 70 mg/dL (B)</p> Signup and view all the answers

    What is the effect of diabetes mellitus on immune function?

    <p>Decreases PMN and macrophage function (B)</p> Signup and view all the answers

    What is the primary complication of chronic hyperglycaemia that affects the kidneys?

    <p>Glomerulosclerosis (C)</p> Signup and view all the answers

    What is the effect of chronic hyperglycaemia on Schwann cells?

    <p>Peripheral neuropathy (D)</p> Signup and view all the answers

    What is the minimum fasting plasma glucose level required for a diagnosis of diabetes?

    <p>126 mg/dL (D)</p> Signup and view all the answers

    What is the primary complication of chronic hyperglycaemia that affects the eyes?

    <p>Retinopathy (A)</p> Signup and view all the answers

    What is the primary macrovascular complication of chronic hyperglycaemia?

    <p>Atherosclerosis (D)</p> Signup and view all the answers

    What is the primary effect of chronic hyperglycaemia on renal blood flow?

    <p>Decreases GFR (C)</p> Signup and view all the answers

    What is the primary consideration for dental management of insulin-dependent diabetics?

    <p>Maintaining usual caloric intake and medication regimen (A)</p> Signup and view all the answers

    What is the primary symptom of hypoglycaemia?

    <p>Shakiness (D)</p> Signup and view all the answers

    What is the recommended treatment for a patient experiencing mild hypoglycaemia?

    <p>Administering 15 g oral carbohydrate (B)</p> Signup and view all the answers

    What is the risk associated with SGLT2 inhibitors and surgical procedures?

    <p>Diabetic ketoacidosis (D)</p> Signup and view all the answers

    What should be done to a patient experiencing severe hypoglycaemia?

    <p>Seeking emergency medical assistance (C)</p> Signup and view all the answers

    Why is it important to prioritize dental treatment for poorly controlled diabetics?

    <p>To prevent complications from unmanaged diabetes (D)</p> Signup and view all the answers

    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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