Diabetes Mellitus

Plasma glucose concentration is closely regulated by the autonomic nervous system. Insulin, synthesized by pancreatic β-cells, and glucagon synthesized by pancreatic β-cells, have opposing effects on circulating glucose levels. Glucagon is a hyperglycemic agent that promotes hepatic glycogenolysis and gluconeogenesis. Insulin is a hypoglycemic agent that stimulates cellular glucose uptake. Hyperglycemia is the hallmark of inadequately treated diabetes mellitus (DM).

Type 1 DM is defined as absolute insulin deficiency. Type 2 DM is due to inadequate insulin secretion and/or resistance to the actions of insulin. The treatment of DM includes daily administration of antidiabetic agents (Table 8).17 In the absence of adequate intake of carbohydrates, the treatment leads to hypoglycemia. Patients monitor their blood glucose levels regularly (Figure 1). Key recommendations for practice are presented in Tables 9 and 10.25-29

Figure 1.

Doctor making blood sugar test.
Self Monitoring of Blood Glucose (SMBG) allows patients to assess their glycemic control and alert them to the need to adjust their medications and/or diet. Results of SMBG can be useful in the oral healthcare setting pre-, intra-, and post-treatment to prevent hypoglycemia.
Download PDF - Tables 8-10

Table 8. Antidiabetic Agents in the Top 200.17

CE 509 Table 8 Antidiabetic Agents 1
Table 9. Hyperglycemia: Key Recommendations for Practice.26-29
CE 509 Table 9 Antidiabetic Agents 2

Table 10. Hypoglycemia: Key Recommendations for Practice.26-29

CE 509 Table 10 Antidiabetic Agents 3
Download PDF - Tables 8-10