The Patient Faints in the Waiting Area with a Suspected Hypoglycemic Event.

An older adult with diabetes is taking glipizide, a sulfonylurea class drug. Subsequently, she experiences a hypoglycemic episode in the dental office. Prompt recognition of hypoglycemia and administration of glucose or sugar is vital. Patient and provider education about the risks of hypoglycemia in older adults may help to prevent future hypoglycemic episodes.

An Elderly Patient with Undiagnosed Type 2 Diabetes Mellitus Presenting for an Emergency Extraction.

In this case a patient has multiple risk factors for diabetes including periodontal disease, family history positive for diabetes, and body mass index of 24 in an Asian American. He has no medical or dental home and upon presenting to the dental office would be a good candidate for diabetes screening.

A Diabetic Patient with a Recent History of Flap and Osseous Surgery Presents Back with Bleeding and Infection.

A patient with type II diabetes and renal disease developed infection and bleeding after periodontal osseous surgery. The clinician did not adequately assess the patient's long-term glycemic status or stage of chronic kidney disease (CKD) before initiating osseous surgery. Preoperative assessment of patients with diabetes should include at a minimum an Hba1c within 3 months and estimated glomerular filtration rate for CKD.

Patient with Type I Diabetes Mellitus Develops Post-Operative Hyperglycemia After Osseous Surgery.

A patient with type I diabetes withheld her diabetes medications without consulting her physician and was not able to resume her normal diet after extensive dental surgery resulting in hyperglycemia postoperatively. Clear communication between clinicians and patient about the expected postoperative course and changes to factors that may influence glycemic control could prevent hyperglycemia in the postoperative period.

A Pregnant Patient with Gestational Diabetes Reports for Scaling and Root Planning.

In this case a woman with gestational diabetes and otherwise healthy pregnancy needs scaling and root planning for the treatment of stage I periodontal disease during pregnancy. Her daily blood sugars are in the target range, and there are no contraindications to providing necessary dental treatment under local anesthesia with vasoconstrictors in her case.