Update on diabetes diagnosis and management.
BACKGROUND:The American Diabetes Association has established recommendations for the testing of undiagnosed people. Once diagnosed, those with diabetes must strive to maintain a level of glucose control that results in a metabolism that approaches that of people without diabetes. The dentist also can provide risk-reduction strategies for people prone to develop diabetes, and refer patients with signs and symptoms suggestive of diabetes to physicians. METHODS:The authors describe criteria for establishing a diagnosis of diabetes and for identifying people at high risk of developing the disease. A combination of approaches in the medical management of type 1 and type 2 diabetes mellitus is presented, along with target outcomes. RESULTS:Patients with diabetes maintain a glycosylated hemoglobin value of no higher than 7 percent. New therapeutic research includes early clinical trials of islet cell transplantation and therapeutic cloning from human stem cells, which may provide an alternate source of insulin-producing islet cells and, thus, may offer a potential cure for diabetes. CONCLUSIONS:Rigorous metabolic control of diabetes can be achieved through a combination of therapeutic modalities and the establishment and maintenance of target outcomes. The dentist can implement preventive strategies and refer patients with signs and symptoms suggestive of diabetes to physicians. CLINICAL IMPLICATIONS:The dentist and physician must work together as a team to achieve rigorous metabolic control of diabetes in their patients.
Robertson, C; Drexler, AJ; Vernillo, AT
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