The dentist referred the patient for a diabetic workup after he saw that the patient's mandibular trabecular bone appeared to be sparse (as in a diabetic patient) in a panoramic radiograph. Her 2-hr postprandial level is within range (135mg/dl) however it is close to the upper limit. The patient is worried and wants to do further workup. Is it necessary?
Alndil of postprasingle random value ab1of 135mg/dl may not tell the true picture as one neeeds the Hb1Ac levels for longterm control and what the dentist is planning for the mandibular bone and if any surgery is planned it may be important to shift to some human insulin and on which drug is this level of postprandial sugar achieved all detals are necessary
How about her 3 independent fasting blood glucose levels? It is fairly inexpensive and straightforward.
If fasting levels are questionable, it would make sense to measure HA1c.
There is no surgery planned for the mandibular bone. He ordered it to check if a root canal is needed for one of her teeth. However it is not needed.
Thank you.
I agree that fasting blood glucose and HbA1C are important to clarify the situation. Double-checking the postprandial level is also important,
if patient can afford then besides cjecking fasting bld sugar Hb1Ac will add to information considering she has gone to the extent of mandibular involvement ,although no su enough apeated fbs may bed jusr rergery is required although only if cant affors iauseef suggested.
We would need a little more information to answer this question. What type of diabetes and what treatment is the patient on for their diabetes?
A postprandial glucose at this level would suggest near normal glycaemic control and certainly would suggest no need for further work up other than your standard peri-operative routine.
The patient is not a diabetic. She is a healthy 24 year old. She has no chronic medical illnesses. She has a balanced diet.
She is worried because of what her dentist said.
Update:
A random blood sugar test was done, the level was 110mg/dl, and her HbA1c level is 5.7%.
A postprandial glucose level with 135mg/dl is normal. Her HbA1c level is also normal. Not important.
2 FBS above 126 mg/dl , postprandial after OGTT above 200 and HbA1c >6.4 is diabetes. FBS = 100-125, postprandial after OGTT 140- 200 and HbA1c 5.7-6.4 is pre-diabetes. random BS=200 with diabetes symptom is diabetes. So, one Bs=135 is normal.
I agree with this response:
2 FBS above 126 mg/dl , postprandial after OGTT above 200 and HbA1c >6.4 is diabetes. FBS = 100-125, postprandial after OGTT 140- 200 and HbA1c 5.7-6.4 is pre-diabetes. random BS=200 with diabetes symptom is diabetes. So, one Bs=135 is normal.
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