Oral Med, Diabetes

Front 1

Increased fat metabolism leads to the accumulation of ___________ and __________ in the blood and eventual diabetic ketoacidosis.

Back 1

acetone and b-hydroxybutyric acid

Front 2

Signs and symptoms of diabetic ketoacidosis include

Back 2

polyuria, polydipsia, fatigue, nausea, vomiting, tachycardia, tachypnea and mental confusion.

Front 3

Characteristic Kussmaul respirations occur when

serum pH drops below_________

Back 3

7.24

Front 4

Granulocyte _________, __________ and ___________ are reduced by hyperglycemia.

Back 4

phagocytosis, chemotaxis, and adherence

Front 5

Hyperglycemia inhibits __________________and__________synthesis , __________, and ___________

Back 5

protocollagen and collagen,

capillary ingrowth, fibroblast

Front 6

Type 1 Diabetes Mellitus - ___%~ of cases; peak incidence ______ . Type 1 is characterized by _______. Ketoacidosis is a concern.

Back 6

10%,

during puberty,

absolute insulin deficiency

Front 7

Type 2 Diabetes Mellitus – _______% of cases; Characterized by a relative insulin deficiency (insulin resistance). More common in patients over __ years of age.

Back 7

90-95%, 45 yoa

Front 8

Secondary Diabetes Mellitus – Relatively uncommon. Etiologies

Back 8

include genetic defects, drugs, chemicals, infections and endocrinopathies.

Front 9

SYMPTOMS:
diabetes

Back 9

polydipsia, polyphagia and polyuria, weight loss, pruritis (ass itch) and polyneuritis.

Front 10

DIAGNOSIS:
diabetes

Back 10

FPG >126mg/dl on two occasions. 110=normal
Or
2h PG>200mg/dl glucose tolerance test.
(<140 mg/dl)=normal
Or
Symptoms of diabetes (polyphagia, polydypsia, polyuria, weight loss) plus casual glucose concentration>200mg/dl

Front 11

Systemic complications of diabetes:

Back 11

Retinopathy, nephropathy, HTN, neuropathies, ^infection, impaired wound healing, coronary artery disease, cerebrovascular and peripheral vascular disease

Front 12

Oral complications of diabetes:

Back 12

Oral burning, altered taste, ^ infection, poor wound healing, diminished salivary flow, ^crevicular glucose,

^plaque microflora, ^ periodontitis, ^caries, ^fungal infections.

Front 13

The glycosylated hemoglobin assay (HbA1c) reflects mean blood glucose levels over the preceding_____________. It is utilized to assess whether a patients metabolic control has remained within the target range (normal value ________)

Back 13

2 –3 months,

7%

Front 14

Hypoglycemia/ Insulin shock - Rapid onset noted. Signs and symptoms

Back 14

include hunger,

weakness,

tachycardia,

pallor,

sweating, incoherence, belligerence, tonic-clonic movements (seizure),

hypotension,

hypothermia,

loss of consciousness

Front 15

Hyperglycemia/ Ketoacidosis -
Symptoms

Back 15

polydipsia, polyphagia, and polyuria.

weight loss, blurred vision, headache, fatigue, nausea, vomiting and mental stupor.

Front 16

Oral Adverse effects of Oral Hypoglycemics

Back 16

Sulfonylureas: Oral ulcerations secondary to agranulocytosis, peri-oral dermatitis
Metformin – metallic taste

Front 17

Dental Drug interactions: Drugs

Back 17

Salicylates
Naproxen
Epinephrine
Glucocorticoids
Morphine

Front 18

Dental Drug interactions:

Potentiates Sulfonylurease

Back 18

Salicylates

Front 19

Dental Drug interactions:Induces hypoglycemia

Back 19

Salicylates
Naproxen

Front 20

Dental Drug interactions:Induces hyperglycemia

Back 20

Epinephrine
Glucocorticoids
Morphine

Front 21

• Complete medical history including

Back 21

severity and extent of systemic complications; glycemic control;

medications (type, dose, time of administration), compliance with diet,

exercise and frequency of self-monitoring

Front 22

• Medical consultation is recommended for:
 Poorly controlled diabetics or those with serious complications such as
___________ _____________ or_______

Back 22

atherosclerosis, hypertension or nephropathy

Front 23

• Management of a hypoglycemic episode: Administer ~ _________ of fast acting oral carbohydrate (glucose tabs/gel, juice, soft-drinks, sugar, candy). If equipped administer IV dextrose (____)

Back 23

15 grams,

5%

Front 24

Avoid ___________ which can alter glycemic control.

Back 24

salicylates

Front 25

Hyperglycemia/ Ketoacidosis - onset

Back 25

Slow

Front 26

Hyperglycemia/ Ketoacidosis :

Clinical signs

Back 26

dry warm flushed skin,

deep rapid respirations (Kussmaul’s respirations), fruity acetone breath (if ketoacidosis present) tachycardia and hypotension.

Front 27

HbA1c

Back 27

glycosylated hemoglobin assay

Front 28

Diabetes DX;

-FPG >_______on two occasions. (Normal FPG<____mg/dl))
-2 Hour Plasma Glucose (2h PG)>___mg/dl durin
(Normal 2 hour plasma glucose <___ mg/dl)
Or
Symptoms of diabetes (polyphagia, polydypsia, polyuria, weight loss) plus casual glucose concentration>______

Back 28

126mg/dl 110=N,

200mg/dl 140=N,

200mg/dl

Front 29

autoimmune destruction of pancreatic b-cells

Back 29

Type 1 diabetes