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5 Things Every Diabetic Should Know About Hba1c

5 Things Every Diabetic Should Know About Hba1c

If you or someone you love has diabetes, you may have heard the term “Hemoglobin A1c,” or HbA1c, in reference to tests that monitor blood sugar levels. Monitoring HbA1c is an important part of diabetes care, and it can have a huge impact on your ability to maintain a healthy mouth and body. These essential facts on HbA1c will show what the numbers are all about. 1. Measures the Sugars Attached to Your Blood Cells Your HbA1c value gives the percentage of red blood cells that have glucose (sugar) attached to them. Because red blood cells live for about 3 months, the HbA1c test measures the average blood sugar levels across a two or three-month period (according to WebMD). If your HbA1c level is higher, more sugar is bound to your blood cells. 2. HbA1c Tests Give a Broad Perspective HbA1c values are used to measure your blood sugar control over time, which differs from blood glucose readings that diabetic patients take multiple times per day. The main difference is that an HbA1c test will let your doctor learn about your blood sugar levels over a long period, while glucose readings only provide information about the past few hours. High HbA1c numbers may be a warning sign of diabetes or of complications from uncontrolled diabetes – diminished healing, blindness, and even kidney failure. 3. Diabetes Can Affect Oral Health If you have diabetes, be sure to take the time to discuss your condition with your dentist and dental hygienist. Many people with diabetes are at increased risk of gum disease, dry mouth, fungal infections, tooth decay, and mouth ulcers. Diabetes may also diminish and slow your ability to heal after dental surgeries such as tooth extractions. Maintaining a target HbA1c value (as advised by your doctor) can lower your risk for oral health complication Continue reading >>

Preoperative A1c And Clinical Outcomes In Patients With Diabetes Undergoing Major Noncardiac Surgical Procedures

Preoperative A1c And Clinical Outcomes In Patients With Diabetes Undergoing Major Noncardiac Surgical Procedures

OBJECTIVE To evaluate the relationship between preoperative A1C and clinical outcomes in individuals with diabetes mellitus undergoing noncardiac surgery. RESEARCH DESIGN AND METHODS Data were obtained from the National Surgical Quality Improvement Program database and the Research Patient Data Registry of the Brigham and Women’s Hospital. Patients admitted to the hospital for ≥1 day after undergoing noncardiac surgery from 2005 to 2010 were included in the study. RESULTS Of 1,775 patients with diabetes, 622 patients (35%) had an A1C value available within 3 months before surgery. After excluding same-day surgeries, patients with diabetes were divided into four groups (A1C ≤6.5% [N = 109]; >6.5–8% [N = 202]; >8–10% [N = 91]; >10% [N = 47]) and compared with age-, sex-, and BMI-matched nondiabetic control subjects (N = 888). Individuals with A1C values between 6.5 and 8% had a hospital length of stay (LOS) similar to the matched control group (P = 0.5). However, in individuals with A1C values ≤6.5 or >8%, the hospital LOS was significantly longer compared with the control group (P < 0.05). Multivariate regression analysis demonstrated that a higher A1C value was associated with increased hospital LOS after adjustments for age, sex, BMI, race, type of surgery, Charlson Comordity Index, smoking status, and glucose level on the day of surgery (P = 0.02). There were too few events to meaningfully evaluate for death, infections, or readmission rate. CONCLUSIONS Our study suggests that chronic hyperglycemia (A1C >8%) is associated with poor surgical outcomes (longer hospital LOS). Providing a preoperative intervention to improve glycemic control in individuals with A1C values >8% may improve surgical outcomes, but prospective studies are needed. Diabetes mellitus i Continue reading >>

Why Dental Problems Make It Hard To Control Blood Glucose

Why Dental Problems Make It Hard To Control Blood Glucose

The nearly 30 million people living with type 2 diabetes may be surprised to learn about another unintended difficulty: dental problems, namely gum disease. People with diabetes are at an increased risk for serious gum disease, or what's known as periodontitis, because they are generally more susceptible to bacterial infection, and have a decreased ability to fight bacteria that invade the gums. On the flip side, serious gum disease may have the potential to affect blood-glucose control and contribute to the progression of diabetes. Too much glucose or sugar in your blood from the diabetes can cause pain, infection, and other problems in your teeth and gums because it helps allow harmful bacteria to grow in your saliva. These bacteria combine with food to form plaque, a soft, sticky film that causes tooth decay or cavities. If you have uncontrolled blood sugar, you're more likely to develop gum disease than someone who doesn't have diabetes. Other dental complications related to uncontrolled diabetes include thrush, an oral fungus, and dry mouth, which can cause sores and ulcers. If you've been diagnosed with diabetes, the better you control your blood glucose, the lower your risk is for periodontitis. 5 Simple Ways to Prevent Diabetes-Related Gum Disease To help prevent dental problems: Brush your teeth at least twice daily. Floss once a day, pressing the floss against your teeth and not your gums. Check for areas where your gums are red or painful. See your dentist right away if you think you have a problem. If you are having dental work, be sure to remind the hygienist and dentist that you have diabetes. Many dental treatments can affect your blood sugar. Your dentist may decide to delay some procedures — including dental surgery — if your blood-glucose levels ar Continue reading >>

Dental Treatment Helps Lower Your Hemoglobin A1c

Dental Treatment Helps Lower Your Hemoglobin A1c

Dental Treatment Helps Lower Your Hemoglobin A1c With Miguel Vinas, PhD, and Amy Hess-Fischl, MS, RD, LDN, BC-ADM, CDE If you're trying to manage your blood sugar, and you have gum disease, a trip to the dentist appears likely to reduce your risk of diabetes and lower your hemoglobin A1c levels.1 Hemoglobin A1c is a test that reflects a persons average blood sugar levels over the past three months. According to a study from Spain,1 a dental treatment known as scaling and root planing lowered blood sugar levels in individuals with type 2 diabetes who received periodontal carea more intensive plaque removalwhen compared to those who got less intense oral cleaning to treat their gum disease. You may be interested in these related articles: Treatment for periodontal disease will improve hemoglobin A1c in people with type 2 diabetes. Periodontal disease is caused by a build-up of plaque, the sticky bacterial film always forming on the teeth, especially at the gum line. This plaque build-up leads to an infection of the tissues that surround and support your teeth. When not treated, gums maybleed and can begin to pull away from the teeth, eventually causing tooth loss. A Healthy Mouth Improves Blood Sugar Control In this six-month study,1 people who underwent the root planing and scaling procedure had lower hemoglobin A1c levels than a process of removing the plaque with ultrasound, says Miguel Vinas, PhD, a study coauthor, and researcher at the University of Barcelona. Examining the Role of Gum Disease and Blood Sugar Control The researchers randomly assigned 90 people diagnosed with type 2 diabetes who had an average hemoglobin A1C of 7.7% at the start to either the scaling and root planing group or the ultrasound group. At three months and again at six months, the research Continue reading >>

Turkish Diabetes Foundation - Turkish Dental Association

Turkish Diabetes Foundation - Turkish Dental Association

NATIONAL DIABETES CONSENSUS GROUP AND TURKISH DENTAL ASSOCIATION COMMISSION FOR THE DEVELOPMENT OF COLLABORATION IN THE FIELD OF GENERAL HEALTH AND ORAL HEALTH 2015 Guidelines in Clinical Dentistry for Diabetes 3 INTRODUCTION The World Health Organization (WHO) and the World Dental Federation (FDI) report that nearly 36 million people die of chronic diseases each year. It is known that non-communicable diseases such as diabetes, cardiovascular diseases or cancer, as well as tooth-decay and gingivitis, pose similar risks. Diabetes is the most serious of all chronic diseases. The Ministry of Health of the Republic of Turkey estimates that there are 7.2 million people with diabetes in Turkey. Diabetes is a lifelong disease that can surface at any stage of life. Critical organ damage may occur in a short period of time if diabetic patients are left untreated or if their blood sugar is not regulated. Diabetes is the number one cause of high blood pressure, obesity, coronary heart disease, stroke (paralysis), chronic kidney failure, blindness over the age of 20 years and leg amputations with the exception of traffic accidents. Clinical studies reveal oral and dental health problems in 80-100% of people with type 2 diabetes and in a significant number of people with type 1 diabetes. Oral health problems are one of the most crucial obstacles preventing blood glucose regulation in diabetic patients. Thus, it is not possible to treat diabetes without first ensuring the oral and dental health of people with the disease. Dentists thus play a critical role in controlling diabetes and improving the quality of life of patients with the disease. In light of the FDI’s Istanbul Declaration, the Turkish Dental Association argues that dentists can have a large impact on the health o Continue reading >>

Diabetes And Teeth: Faq On Wisdom Teeth, Dentures And More - Healthxchange

Diabetes And Teeth: Faq On Wisdom Teeth, Dentures And More - Healthxchange

Diabetes and Teeth: FAQ on Wisdom Teeth, Dentures and More Diabetes and Teeth: FAQ on Wisdom Teeth, Dentures and More Having good oral health is important to those who suffer from diabetes. The Department of Restorative Dentistry at National Dental Centre Singapore answers some oral health questions. do not require special precautions for routine extractions. Dr Chee Hoe Kit , Consultant, Periodontics Unit , Department of Restorative Dentistry, National Dental Centre Singapore (NDCS) , a member of the SingHealth group, answers some frequently asked questions about diabetes and oral health: Q. Should I have my wisdom tooth removed, and what if the bleeding (after the tooth extraction) doesnt stop? A. It is not necessary to have your wisdom tooth removed if it is not impacted or buried and doesnt trap food that can potentially affect adjacent teeth. If there is uncontrolled bleeding after a tooth extraction, bite firmly onto a clean gauze or handkerchief thats placed over the wound, for at least 15-30 minutes. Avoid vigorous exercise, alcohol, very hot food or drink, for the rest of the day to minimise the risk of excessive post-operative bleeding. Do not rinse the wound area unnecessarily, or suck ice cubes, after the tooth extraction as this will disturb the blood clot that has formed inside the wound and stimulate bleeding again. If profuse bleeding persists despite the gauze-bite, return to the dental clinic or go to Accident & Emergency department at the nearest hospital. Q. Do people with diabetes take longer to recover after a wisdom tooth extraction and other dental surgical procedures, than non-diabetics? A. According to a large Australian study carried out in 2013, there is similar healing time between people with type 2 diabetes who are on oral hypoglycaemic m Continue reading >>

Diabetes And Dental Treatment: What You Should Know

Diabetes And Dental Treatment: What You Should Know

Taking care of your teeth and mouth is especially important if you have diabetes, because the condition results in a greater risk of oral infection and often slows the healing process. Seeing a dentist is a slightly different experience for diabetics, and it's important to learn as much as you can about handling your diabetes and dental treatment so you can work with your dentist to avoid complications and maintain your oral health. Diabetes and Oral Health Issues Gum disease and diabetes have an interesting connection. According to the National Diabetes Information Clearinghouse (NDIC), diabetes raises your risk of gum disease. Having gum disease then raises your risk of diabetes complications since gum disease makes it more difficult for a diabetic to keep his or her blood sugar levels under control. The higher your blood sugar levels, the more likely you are to have plaque buildup on your teeth, as explained by the NDIC. When your blood sugar levels are high, the amount of sugar in your saliva is also high, which creates an ideal environment for plaque to grow. Excess plaque not only increases your risk of infection and gum disease; it also raises your risk of cavities and decay. Being proactive about treating your condition and caring for your mouth can help you avoid additional dental work beyond regular cleanings in the future. Tooth- and gum-related problems aren't the only oral health issues that you might face if you don't treat your diabetes or see a dentist regularly. According to the American Diabetes Association, diabetics are more likely to suffer from dry mouth or to develop a fungal infection in their mouths. Dry mouth can occur when your diabetes is uncontrolled or as a side effect of the medication you're taking to control the condition. Having dry mou Continue reading >>

Tooth Extraction And Being Diabetic

Tooth Extraction And Being Diabetic

Diabetes Forum The Global Diabetes Community Find support, ask questions and share your experiences. Join the community Hello everyone! This is my first post here and it comes as a result of some panic. I have 1.5 LADA. I have been told that I need a root canal procedure pretty quickly to save my tooth (#14, upper left, second molar in) but there is no way I can afford one. It's looking more and more every day like I have no other option than to have the tooth extracted, which I wouldn't have to pay for. I have always heard horror stories about that leading to massive infections and did some research. What I'm finding is that if diabetes is uncontrolled (A1C way over 7.0) then it becomes a concern. If it is well-controlled - as mine seems to be (A1C 6.4) - then it's not a huge problem and it should heal pretty quickly. Of course, these are things I'm reading on the internet, so there's always a chance they're inaccurate. Has anyone here ever experienced a tooth extraction while diabetic, and if so, how terrible or painful was it to have done? Did you get infections from it? How did it affect your eating afterwards? How long did it take to heal? Were you able to get an artificial replacement tooth? Anything you can tell me about this will help a great deal. I'm really trying to steel my nerves for when this has to happen. I'm seriously terrified of it. I had an extraction just before Christmas . I had had a gum infection which refused to clear, even with antibiotics, probably because I have a compromised immune system from long term steroid use. I think my blood sugar levels were probably sky high (15+) at this point. I can't be sure as I hadn't been diagnosed and wasn't testing, so I'm guessing from the symptoms. Anyway, the tooth came out, no problems, no pain, took a Continue reading >>

Post-extraction Wound Healing In Patients With Type 2 Diabetes (pewhpd)

Post-extraction Wound Healing In Patients With Type 2 Diabetes (pewhpd)

The purpose of this study is to evaluate clinical healing after dental extraction and the occurrence of surgical complications in patients with type 2 diabetes and compare with non-diabetic patients or control, taking into account laboratory data such as blood count, glycated hemoglobin (HbA1) and immunological profile of the patients. It has been established in scientific literature that patients with diabetes have a greater predisposition to oral complications and that oral infections may compromise their metabolic control. There is scant clinical evidence of a relationship between diabetes and an increased risk of infection after dental extractions. To our knowledge, no prospective longitudinal studies have been designed to prove this hypothesis. The aim of this study is to evaluate clinical healing after dental extraction and the occurrence of surgical complications in patients with type 1 and 2 diabetes and compare with non-diabetic patients, taking into account laboratory data such as blood count, glycated hemoglobin (HbA1) and immunological profile of the patients. Ninety patients shall be prospectively studied, divided into 3 groups: Group 1 will consist of 30 patients with uncontrolled type 2 diabetics patients, group 2 will consist of 30 controlled type 2 diabetics patients and group 3 composed of 30 non-diabetic patients (control group). All patients will undergo extraction of erupted teeth, always carried out by the same dentist (MS). A complete medical history and laboratory tests will be conducted for all patients including: glycated hemoglobin (HbA1), fasting glucose, complete blood count, platelets, prothrombin time (PT), partial thromboplastin time (PTT), immunoglobulins (IgA, IgG and IgM), CD3, CD4, CD8, testing of complement (C3, C4), dihydrorhodamine Continue reading >>

Best Practices For Managing The Diabetic Patient In The Dental Office

Best Practices For Managing The Diabetic Patient In The Dental Office

Brian L. Mealey, DDS, MS; Robert J. Genco, DDS, PhD; and Rachel A. Schallhorn, DDS, MS Abstract With the number of diabetic patients in the United States on the rise and the close association now known to exist between diabetes and periodontal disease, it is critical that oral healthcare providers have an understanding of best practices for treating this growing population. This article examines the relationship between diabetes and periodontal disease and offers practical considerations for dentists treating diabetic patients. According to the most recent (2014) National Diabetes Statistics Report of the Centers for Disease Control and Prevention, some 29.1 million Americans currently have diabetes, including both type 1 and type 2.1 This constitutes 9.3% of the total US population, with an additional 86 million Americans identified as having prediabetes. Both the incidence and prevalence of diabetes have been steadily increasing.2 A chronic inflammatory disorder, diabetes is associated with significant morbidity and mortality and is a leading cause of kidney failure, blindness, limb amputation, myocardial infarction, and stroke. It also is now understood to have a two-way relationship with periodontal disease, with poor glycemic control adversely affecting the periodontium, and inflammatory periodontal diseases associated with potential negative effects on glycemic control.3 Given the growing number of diabetic patients (Table 1) and the close association between diabetes and periodontal disease, it is incumbent on oral healthcare practitioners to be aware of the best practices for treating this population. The aim of this article is to review some of these practices. Background Some understanding of the relationship between diabetes and periodontal disease dates back Continue reading >>

Voice Of The Diabetic

Voice Of The Diabetic

A Wake-Up Call From the Editor: Marilyn Brandt Smith lives in Louisville, Kentucky, with her husband Roger and their son Jay. The Smiths are retired teachers, and Marilyn is also a freelance writer and editor. My husband's talking watch announced that it was 6:00 p.m. when the phone rang. Thanks to his audio caller ID, he knew instantly who was calling that April evening. But the doctor's office should have been closed. Did surgeons work this late? "You have to get your blood glucose down, or we aren't doing your surgery next week," said the voice on the other end of the line. My fifty-six-year-old husband Roger had been suffering from infections, headaches, congestion, and pain, and, when he went to the doctor to investigate the cause, they found a tooth fragment lodged in his sinus cavity, the result of a routine tooth extraction last summer. Since Roger was diagnosed with type 2 diabetes at age forty-eight, he had been managing with oral medication, improved diet, and increased exercise. He lost fifty pounds, and, although his A1C has crept up in recent years, he thought he was in reasonably good control. Then the surgeon called to report a blood glucose level of 270 mg/dl, more than double what a fasting glucose should be. Something had to change and fast. Diabetes runs in Roger's family, and he has always known he might someday need to go on insulin. Although Splenda and other sugar-free goodies appear regularly on our grocery list, his diet is not as good as it should be. He was, and still is, a great fan of the all-you-can-eat buffet. The morning after that disappointing phone call, we went to see our family doctor, and Roger got an A1C test. The result left everyone speechless: His A1C was 9.3 percent--far too high. Our doctor knew that Roger would prefer to avo Continue reading >>

Dental Considerations With A Diabetic Patient

Dental Considerations With A Diabetic Patient

Home / Dentists / Risk Management / Dental Insights / Dental Considerations with a Diabetic Patient Dental Considerations with a Diabetic Patient Mary was in her late 40s and a freelance writer when she first visited the group dental practice owned by Dr. Simon. Mary went to the practice at the urging of her roommate Dominique who convinced her of the importance of regular dental care. Mary had only sporadically been to a dentist in the past several years. Dominique was good friends with Dr. Simons dental assistant Ella. Mary was seen on November 28, 2012, by Dr. Coe, an associate of Dr. Simon, who performed an initial examination including radiographs. Dr. Coe then prepared a comprehensive treatment plan that included a Family and Friends discount, which he discussed with Mary. As part of the initial treatment plan, Dr. Coe recommended scaling and root planings to treat some mild to moderate periodontal issues, as well as a possible root canal on the upper right and a few minor restorations. He also advised extracting a lower right molar (tooth 30) that was asymptomatic but was significantly decayed. Mary indicated on her health history that she was taking metformin for Type 2 diabetes. She was also noted to be overweight. In conversations with Dr. Coe, Mary indicated she was a controlled diabetic. Dr. Coe did not ask for specific values of diabetes testing, nor did he contact her regular physician. He did note she was not in pain during the visit. Mary promptly returned for her initial scaling and root planing appointment on December 28, 2012, at the end of which she was directed to schedule a follow-up scaling and root planing appointment as well appointments for her extraction, root canal and restorations. Since she had developed pain from the carious molar, she sc Continue reading >>

What Is The Recommended Blood Glucose Level For Tooth Removal?

What Is The Recommended Blood Glucose Level For Tooth Removal?

In hospital dental practice (while dealing with high risk patients), the main rule that is followed is, in cases of an uncontrolled medical condition, all elective procedures should be avoided. On the other note, in the same patient, any emergent condition that can be life-changing or life threatening must be performed as soon as possible while simultaneously treating the uncontrolled condition. As an oral and maxillofacial surgeon, we have had to do extractions in patients with their blood glucose levels > 300 mg/100ml! This became necessary because the tooth was the cause of serious fascial space infection in that patient. The patient was being intensively treated for controlling his diabetes and removal of the foci of infection can also help in his glycemic control as infective states can worsen glycemic control. The main issue of blood sugar is not during the extraction procedure, but what may happen after the procedure during the healing period as in delayed wound healing, dry socket or even osteomyelitis. Co existing conditions in a diabetic (like hypertension) may affect the outcome. The mere increased blood glucose levels are not a risk factor during the procedure. They tolerate the procedure well but in the post extraction period, some complications may be anticipated. Meticulous management of these complications can help avoid issues. Also, in most uncontrolled diabetics, the problem tooth requiring extraction is usually periodontally compromised and mobile. A uncontrolled diabetic who is on oral hypoglycemic agents will require about 2 weeks before he is reassessed when his glycemic status will be deemed to be in control. In this two weeks, the patient may need to be on prolonged medications (antibiotics, analgesics etc;) and that can have additional complica Continue reading >>

Diabetes, Dental Implants And Bone Graftsis It Safe?

Diabetes, Dental Implants And Bone Graftsis It Safe?

Diabetes, Dental Implants and Bone GraftsIs it Safe? You may be reading this because you are at a diabetic in need of an extraction and bone graft or full mouth dental implants . You are probably well aware that diabetes can cause slow healing from dental surgery or any type of surgery. You can be at a higher risk of complications because of being a diabetic. So how do I do dental implants and bone grafts on diabetics? VERY Carefully!!! Diabetes affects all organ systems. Big fluctuations in blood sugar cause your healing to be impaired. Diabetics are prone to problems with feet, eyes and kidneys but oftentimes develop periodontal disease/gum disease which has likely led you to this point to read about implants and extractions. I tell all my diabetic patients that you must be extremely diligent in the care of your teeth even more so than someone that does not have diabetes. This is because you are more prone to lose them and replacing teeth with implants is more difficult than your situation difficult but not impossible. In these photographs I show two patients that have had similar treatment at the same 7-10 day follow-up. I treated both patients. You can see that the patient that has diabetes that is not well managed is healing much slower than the patient that does not have diabetes. This is not always the case but this is a great example! Diabetic that is not well managed is healing much slower Neither one of these patients had bone grafting in addition to the implants they only had four implants placed in the same area for a lower dental implant overdenture . They are both females in their 60s. You are probably familiar with taking your blood sugar. These numbers need to be as low as possible in the good range. Blood sugar testing should be routine and a very impo Continue reading >>

The Effects Of Elevated Hemoglobin A1c In Patients With Type 2 Diabetes Mellitus On Dental Implants

The Effects Of Elevated Hemoglobin A1c In Patients With Type 2 Diabetes Mellitus On Dental Implants

Go to: Abstract The authors conducted a prospective cohort study to determine whether poor glycemic control is a contraindication to implant therapy in patients with type 2 diabetes. The study sample consisted of 117 edentulous patients, each of whom received two mandibular implants, for a total of 234 implants. Implant-retained mandibular overdentures were loaded after a four-month healing period and followed up for an additional one year. The authors assessed implant survival and stability (by means of resonance frequency analysis) relative to glycated hemoglobin A1c (HbA1c) levels, with baseline levels up to 11.1 percent and levels as high as 13.3 percent over one year. Implant survival rates for 110 of 117 patients who were followed up for one year after loading were 99.0 percent, 98.9 percent and 100 percent, respectively, for patients who did not have diabetes (n = 47), those with well-controlled diabetes (n = 44) and those with poorly controlled diabetes (n = 19). The authors considered the seven patients lost to follow-up as having had failed implants; consequently, their conservative estimates of survival rates in the three groups were 93.0 percent, 92.6 percent and 95.0 percent (P = .6510) . Two implants failed at four weeks, one in the nondiabetes group and the other in the well-con trolled diabetes group. Delays in implant stabilization were related directly to poor glycemic control. The results of this study indicate that elevated HbA1c levels in patients with type 2 diabetes were not associated with altered implant survival one year after loading. However, alterations in early bone healing and implant stability were associated with hyperglycemia. Within the clinical parameters of this study, the findings indicate likely implant success among patients with Continue reading >>

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