The impact of diabetes on treatment in general dental practice

I am disappointed that a peer-reviewed article within a journal of clinical excellence has, within it, some inaccuracies.¹ The article is unclear at times with regards to whether the authors are referring to patients with Type 1 (T1) or Type 2 (T2) Diabetes Mellitus (DM) and, more concerning, is that understanding of DM by the authors is incorrect in the opening statement of the article.

The main presentation of DM is that the undiagnosed or inadequately controlled patient is hyperglycaemic, with a blood glucose elevated over normal physiological range for a period of time, and not hypoglycaemic due to reduced transfer of glucose into muscle cells as the authors state. Indeed, it is hyperglycaemia from which the majority of diabetic complications arise. The name Diabetes Mellitus originates from ancient Greek which literally translates as ‘Sweet/Honey urine’ due to the excessive glucose within the body.

The glycated haemoglobin test (HbA1c) is the most appropriate measure of long term glycaemic control, with a value of over 48 mmol/mol (6.5%) being indicative of DM, although in acute situations a random venous plasma glucose of >11.1 mmol/l would be diagnostic.²