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空腹血糖和糖化血红蛋白水平能否预测 2 型糖尿病患者接受有创性牙科手术后的口腔并发症?一项初步的病例对照研究。

Can fasting plasma glucose and glycated hemoglobin levels predict oral complications following invasive dental procedures in patients with type 2 diabetes mellitus? A preliminary case-control study.

机构信息

Department of Morphology, Stomatology and Physiology, Dental School of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil.

出版信息

Clinics (Sao Paulo). 2013;68(3):427-30. doi: 10.6061/clinics/2013(03)rc01.

Abstract

OBJECTIVE

To evaluate the effects of the levels of glycemic control on the frequency of clinical complications following invasive dental treatments in type 2 diabetic patients and suggest appropriate levels of fasting blood glucose and glycated hemoglobin considered to be safe to avoid these complications.

METHOD

Type 2 diabetic patients and non-diabetic patients were selected and divided into three groups. Group I consisted of 13 type 2 diabetic patients with adequate glycemic control (fasting blood glucose levels <140 mg/dl and glycated hemoglobin (HbA1c) levels <7%). Group II consisted of 15 type 2 diabetic patients with inadequate glycemic control (fasting blood glucose levels >140 mg/dl and HbA1c levels >7%). Group III consisted of 18 non-diabetic patients (no symptoms and fasting blood glucose levels <100 mg/dl). The levels of fasting blood glucose, glycated HbA1c, and fingerstick capillary glycemia were evaluated in diabetic patients prior to performing dental procedures. Seven days after the dental procedure, the frequency of clinical complications (surgery site infections and systemic infections) was examined and compared between the three study groups. In addition, correlations between the occurrence of these outcomes and the glycemic control of diabetes mellitus were evaluated.

RESULTS

The frequency of clinical outcomes was low (4/43; 8.6%), and no significant differences between the outcome frequencies of the various study groups were observed (p>0.05). However, a significant association was observed between clinical complications and dental extractions (p = 0.02).

CONCLUSIONS

Because of the low frequency of clinical outcomes, it was not possible to determine whether fasting blood glucose or glycated HbA1c levels are important for these clinical outcomes.

摘要

目的

评估血糖控制水平对 2 型糖尿病患者接受有创性牙科治疗后临床并发症发生频率的影响,并提出适当的空腹血糖和糖化血红蛋白水平,以确保安全并避免这些并发症。

方法

选择 2 型糖尿病患者和非糖尿病患者,并将其分为三组。第 I 组包括 13 例血糖控制良好的 2 型糖尿病患者(空腹血糖水平<140mg/dl,糖化血红蛋白(HbA1c)水平<7%)。第 II 组包括 15 例血糖控制不佳的 2 型糖尿病患者(空腹血糖水平>140mg/dl,HbA1c 水平>7%)。第 III 组包括 18 例非糖尿病患者(无症状且空腹血糖水平<100mg/dl)。在进行牙科手术前,评估糖尿病患者的空腹血糖、糖化 HbA1c 和指尖毛细血管血糖水平。在牙科手术后 7 天,检查并比较三组患者的临床并发症(手术部位感染和全身感染)发生频率。此外,还评估了这些结果的发生与糖尿病血糖控制之间的相关性。

结果

临床结果的发生率较低(4/43;8.6%),各组间的结果发生率无显著差异(p>0.05)。然而,临床并发症与牙科拔牙之间存在显著相关性(p=0.02)。

结论

由于临床结果的发生率较低,因此无法确定空腹血糖或糖化 HbA1c 水平对这些临床结果是否重要。

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