Impact of Advances in Diabetes Care on Dental Treatment of the Diabetic Patient
You will receive 1 unit(s) of continuing education credit upon successful completion of this course. The registration fee is only $41.00
This course discusses the dental implications of recent advances in the care of diabetic patients.
Upon completion of this course, participants should be able to do the following:
- Discuss the results of the Diabetes Control and Complications Trial study.
- Explain the differences in dynamics of various types of insulin.
- Identify which oral diabetes agents are associated with hypoglycemia.
- Discuss the various conventional and intensive insulin regimens used in insulin-dependent diabetes.
- Describe the signs and symptoms of and treatment for hypoglycemia.
In medicine and dentistry periodically studies are published that have a potentially wide-ranging impact on patient health and management. One such study is the Diabetes Control and Complications Trial (DCCT), which offers new hope for millions of individuals with diabetes and has begun to significantly alter medical management of these patients. Advances in the medical treatment of diabetes require a heightened awareness by dental practitioners of the various treatment regimens of their patients with diabetes, especially because of potential complications associated with diabetes care. Intensive medical treatment with oral agents and exogenous insulin injection promises to decrease the long-term risks of major complications of diabetes, but these treatments increase the risk of medical emergencies, especially hypoglycemia. This article reviews the findings of the DCCT, diabetes treatment regimens that may be encountered in a dental practice, and potential alterations to dental treatment protocols.
- DeSanctis RW, Dec GW: Cardiomyopathies, Chapter XIV. In Dale DC, Federman DD (eds): Scientific American Medicine. New York, Scientific American Inc., pp 1-27, 1995.
- Mealey BL: 1996 world workshop in periodontics, periodontal implications: medically compromised patients. Ann Periodontol 1:256-321, 1996.
- Slavkin HC. Diabetes, clinical dentistry and changing paradigms. J Am Dent Assoc 128:638-644, 1997.
- Goldstein DE, Little RR, Wiedmeyer HM, et al: Is glycohemoglobin testing useful in diabetes mellitus? Lessons from the diabetes control and complications trial. Clin Chem 40:1637-1640, 1994.
- Diabetes Control and Complications Trial Research Group: The diabetes control and complications trial (DCCT): Design and methodologic considerations for the feasibility phase. Diabetes 35:530-545, 1986.
- Diabetes Control and Complications Trial Research Group: The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med 329:977-986, 1993.
- Diabetes Control and Complications Trial Research Group: Progression of retinopathy with intensive versus conventional treatment in the diabetes control and complications trial. Ophthalmology 102:647-661, 1995.
- Diabetes Control and Complications Trial Research Group: Effect of intensive diabetes management on macrovascular and microvascular events and risk factors in the diabetes control and complications trial. Am J Cardiol 75:894-903, 1995.
- American Diabetes Association position statement. Implications of the diabetes control and complications trial. Diabetes Spectrum 6:225-227, 1993.
- Crofford OB: Diabetes control and complications. Annu Rev Med 46:267-279, 1995.
- American Diabetes Association: Standards of medical care for patients with diabetes mellitus. Diabetes Care 18(suppl 1):8-15, 1995.
- Thompson CJ, Cummings JF, Chalmers J, et al: How have patients reacted to the implications of the DCCT? Diabetes Care 19:876-879, 1996.
- Lebovitz HE: Oral antidiabetic agents. In Kahn CR and Weir GC (eds): Joslin's Diabetes Mellitus. Philadelphia, Lea & Febiger Co., pp 508-522, 1994.
- Rosenzweig JL: Principles of insulin therapy. In Kahn CR and Weir GC (eds): Joslin's Diabetes Mellitus, ed 13. Philadelphia, Lea & Febiger Co., pp 460-488, 1994.
- Peterson KA, Smith CK: The DCCT findings and standards of care for diabetes. Am Fam Physician 52:1092-1098, 1995.
- Nathan DM, Singer DE, Hurxthal K, Goodson JD: The clinical information value of the glycosylated hemoglobin assay. N Engl J Med 310:341-346, 1984.
- Diabetes Control and Complications Trial Research Group: Epidemiology of severe hypoglycemia in the diabetes control and complications trial. Am J Med 90:450-459, 1991.
- Diabetes Control and Complications Trial Research Group: Hypoglycemia in the diabetes control and complications trial. Diabetes 46:271-286, 1997.
- Rees TD: The diabetic dental patient. Dent Clin North Am 38:447-463, 1994.
- Galili D: Oral and dental complications associated with diabetes and their treatment. Compend Contin Educ Dent 15:496-509, 1994.
- Heller SR, Herbert M, MacDonald IA, Tattersall RB: Influence of sympathetic
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