Insulin and Oral Agents for diabetics

The information provided here is not intended as a substitute for professional medical advice, diagnosis, or treatment. It is provided to help you communicate effectively with your oral and maxillofacial surgeon or health care provider.

Before having any surgery (especially dental procedures), tell your oral surgeon, dentist or, physician about this medication and all medications and supplements you are taking.

What is Diabetes?

Diabetes is the condition in which the body does not properly process food for use as energy. Much of the food we eat is turned into glucose, or sugar, for our bodies to use for energy. The pancreas, an organ that lies near the stomach, makes a hormone called insulin to help glucose get into the cells of our bodies. When you have diabetes, your body either doesn’t make enough insulin or can’t use its own insulin as well as it should. This causes sugars to build up in your blood.

How Does Diabetes Affect My Oral Health?

If you have diabetes, it is particularly important to maintain excellent oral health. That’s because diabetics are more prone to oral infections such as periodontal (gum) disease, which can result in tooth loss if left untreated. Conversely, the presence of gum disease can make it harder for people with diabetes to control their blood sugar levels.

Overall, diabetic patients respond to most oral surgery procedures similarly to the way nondiabetic patients respond. However, this depends on a number of factors, including, but not limited to oral hygiene, diet, habits such as tobacco use, proper dental care, overall oral health, and metabolic control of your diabetes.

How is the Diabetic Patient Taking Insulin or Oral Agents Managed When Undergoing Oral Surgery?

Pre-Operative Appointment:

  • Completion of an accurate medical history shall be obtained.
  • Your blood glucose level shall be obtained and recorded.
  • If necessary, your physician may be contacted regarding management of your medications and diet modification.
  • Appointment scheduling for surgery  is often determined by your medication regimen. For many patients an early morning appointment for surgery is recommended. However, it is best to schedule your surgery either before or after periods of peak insulin activity.

The Day of Surgery (Before Coming to Your Appointment):

  • Please check your blood glucose. If the level is near the lower end of the normal range, do not take any medications to lower your blood sugar.
  • An adjustment of dose of insulin or oral agents possibly may be recommended.

Surgery Appointment:

  • The surgical assistant shall check your blood glucose level prior to surgery and post-operatively.
  •  IV Sedation is routinely recommended to reduce stress.

Post Operative Phase:

  • Adequate pain control and stress reduction is very important.
  • Diet is a major component of diabetes management.  To avoid hypoglycemia, it is important that the total caloric content and the protein-carbohydrate-fat ratio of the diet remain the same so that proper glycemic control of the diabetes is maintained.

The most important thing is to maintain your blood sugar as close to normal as possible before, during, and after surgery.