Parnell A G
Int Dent J. 1986 Jun;36(2):77-82.
Diabetes mellitus is found in up to 5 per cent of the population. There is an excess of blood sugar due to a deficiency or diminished effectiveness of insulin. It is a complex disease which, if not controlled, has many major complications including an increased incidence of heart attacks, strokes and vascular changes in many other organs. The management of young onset diabetic patients is directed towards: controlling the carbohydrate intake, testing the blood sugar by the patient and regular insulin injections. Great care must be taken in treating diabetics in the dental surgery. Except for children, any diabetic can be treated for simple dental procedures by ensuring freedom from pain, by eliminating stress and by ensuring that the patient does not miss a meal. Children, unstable diabetic patients and those with infections or requiring multiple extractions should be treated in hospital under the care of an endocrinologist. In hypertension it is only after a number of years that complications begin to appear. The main ones are those of stroke, retinal haemorrhages, renal failure and heart disease. Dentists should be encouraged to take the blood pressure of all adults who present for treatment. Patients with increased blood pressure yet controlled by drugs may be treated as normal patients. Those that are not well controlled should be referred to their physician. Dental appointments must be free of pain and stress should be avoided. A screening method is presented which assists in the evaluation of medically compromised patients.
高达5%的人口患有糖尿病。由于胰岛素缺乏或效力降低，血糖会升高。这是一种复杂的疾病，如果不加以控制，会引发许多严重并发症，包括心脏病发作、中风以及许多其他器官的血管病变。年轻糖尿病患者的治疗目标包括：控制碳水化合物摄入量、患者自行检测血糖以及定期注射胰岛素。在牙科诊所治疗糖尿病患者时必须格外小心。除儿童外，任何糖尿病患者都可以通过确保无痛、消除压力以及确保患者不遗漏一餐来进行简单的牙科治疗。儿童、不稳定的糖尿病患者以及有感染或需要多次拔牙的患者应在医院内分泌科医生的照料下接受治疗。高血压患者只有在数年之后才会开始出现并发症。主要并发症包括中风、视网膜出血、肾衰竭和心脏病。应鼓励牙医为所有前来就诊的成年人测量血压。血压升高但通过药物得到控制的患者可以像正常患者一样接受治疗。那些血压控制不佳的患者应转诊给他们的医生。牙科预约必须无痛，应避免压力。本文介绍了一种有助于评估有医疗问题患者的筛查方法。
