Dental Hygienist Management Of Diabetes Melllitus (DM)

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Diabetes Mellitus Diabetes mellitus (DM) is one of the leading chronic, lifelong condition worldwide. DM can cause high rates of morbidity and mortality due to complications associated with the disorder. DM is characterized by hyperglycemia due to a lack of insulin, insulin resistance, or can be consisted of both. The four main types of diabetes mellitus include type 1 diabetes mellitus, type 2 diabetes mellitus, gestational diabetes mellitus, and other specific types (Darby, 2015, 824). A high rate of periodontal disease has been reported with type 1 and type 2 diabetes mellitus (Al-Maskari, et al. 2011). Other manifestations are associated with diabetes mellitus that can cause discomfort for patient. It is important for the dental hygienist …show more content…
An increase in exercise for at least 150 minutes or week is considered a lifestyle change for a diabetic patient; however, the exercise must be tailored according to physical and functional abilities of the patient (Darby, 2015, 823). DM patient’s can have poor nutrition diets and can benefit from nutritional counseling. Insulin therapy is most common used to control to glucose levels in patient’s with DM. Insulin is administered by a subcutaneous injection due to the inability to absorb from the GI tract (Haveless, 2011, 256). The most common adverse reaction related to insulin is hypoglycemia. Hypoglycemia can be caused by insulin overdose, increased amount of stress, or failure to eat (Haveles, 2011, 257). Therefore, it is important for the dental hygienist to provide a stress free environment. The dental hygienist should also schedule dental appointment 1.5 to 2 hours after a patient has eaten and has taken regular antidiabetes medication (Haveles, 2011, 254). Insulin agents have a major difference related to the onset and duration of action. The action of insulin can be divided into rapid-acting, short-acting, intermediate acting, and long-action (Haveles, 2011, 256). Dental cautions related to an increase or sudden decrease of insulin can include epinephrine, glucocorticoids, or opioids (Haveles, 2011, 254). General anesthetics should be used with caution due to an increase risk of acidosis (Haveles, 2011, 254). Pharmacological agents for DM include biguanides, sulfonylureas, meglitinides, thiazolidinediones, alpha-glucosidase inhibitors, and dipeptidyl-peptidase 4 inhibitors (Darby, 2015, 831). Biguanides, is the most commonly prescribed for patient’s that are obese or underweight (Olokaba et al., 2012). Biguanides work by decreasing the amount of glucose secreted by the liver and increasing the action of insulin (Darby, 2015, 831). A contraindication for

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