Foundations in Continuing Education

The Dental Patient with Diabetes

Chapter Fourteen - Prevention and Treatment of DM


Chapter 1: Glucose Metabolism and Hormonal Regulation Review

Chapter 2: Diabetes Mellitus

Chapter 3: Diabetes Mellitus Type 1

Chapter 4: Diabetes Mellitus Type 2

Chapter 5: Gestational Diabetes Mellitus (GDM)

Chapter 6: Pre Diabetes: Impaired Glucose Homeostasis

Chapter 7: Other Specific Types of Diabetes

Chapter 8: Diagnosing Diabetes

Chapter 9: Diagnosis

Chapter 10: Glucose Monitoring

Chapter 11: Complications of Diabetes

Chapter 12: The Dental Patient with Diabetes

Chapter 13: Successful Intervention of Diabetic Emergencies

Introduction
Diet/Nutrition
Exercise
Pharmacological
Intervention

Administration
Method of Injection
Oral Hypoglycemic
Agents

Secretagogues
Biguanides (Metformin)
Thiazolidinediones
(Actos, Avandia)

Glucosidase Inhibitors
(Precose, Glyset)

Combination
Medications

Chapter 15: Diabetes Medications

Chapter 16: Conclusion

Glossary

Appendices

References

Post Examination

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Method of Injection

As stated previously, insulin cannot be delivered orally because stomach acids render it useless before any action can take place.

Current methods of insulin delivery include:

  • Needle and syringe
  • Insulin pump
  • Insulin pen
  • Jet injector

Worn outside the body, an insulin pump delivers a continuous supply of insulin through a tube that connects to a needle placed under the skin. This amount may be supplemented before meals depending on blood glucose levels.

An insulin pen is a device that stores replaceable insulin cartridges with a sterile, disposable needle. These devices eliminate the need to carry extra bottles and needles.

Using high pressure to expel the insulin through the skin, jet injectors do not require a needle. This is an expensive option for insulin delivery.

Jet Nebulizers are currently being researched as a method for delivering insulin. This method is best described as "inhaled" insulin. Thus far no significant adverse reactions have been noted but efficacy is questionable.

When injecting insulin it is important to choose the correct location. It is critical to rotate sites following a regular pattern. Uptake of insulin is fastest in the abdomen and slowest from the buttocks. Repeated injections in the same area may cause delayed absorption. Quicker absorption of insulin can result from exercising (arms and legs) the area of injection.

Patients should be aware of the following information when purchasing insulin.

  • Species (bovine, porcine, human)
  • Brand Name (Humulin, lletin, etc.)
  • Type (NPH, Regular, Lente, etc.)
  • Concentration (U-100 is most common)

Continue on to Oral Hypoglycemic Agents