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"Diabetes mellitus is a group of metabolic diseases characterized by hyperglycemia resulting from defects in insulin secretion, insulin action or both". (18) There is no known cure for diabetes mellitus. The new classification system more accurately reflects improved understanding of the etiology and pathophysiology of this disease.
The new upper limit of "normal" blood sugar level (100 mg/dL) is based on the level at which micro and macrovascular complications may arise. The provisional diagnostic fasting blood glucose level of  126mg/dL was determined in order to standardize results from different blood glucose testing methods.
Prevention efforts should be directed toward educating the general public as to risk factors associated with diabetes mellitus. Treatment goals are achieving metabolic control and preventing/minimizing complications.
Treatment may include diet and exercise modification, insulin and/or oral hypoglycemic drug therapy and professional monitoring of the disease by a variety of health care providers. Complications of diabetes mellitus can affect the eyes, kidneys, cardiovascular system, nervous system, and oral cavity. Acute complications of this disease are hypoglycemia and hyperglycemia (diabetic ketoacidosis, hyperglycemic hyperosmolar nonketotic syndrome).
Dental professionals should be aware of the etiology and pathogenesis of diabetes mellitus. Many individuals seen in the dental office are undiagnosed diabetics and may present with oral conditions indicating metabolic disturbance. The most common dental complication associated with diabetes is periodontal disease. Thorough health history taking and oral assessment is necessary to identify and manage diabetic individuals. The dental profession has an important role in helping diabetics control their disease. Dental visits provide an opportunity to educate the patient about maintaining oral health and overall diabetes management.
Diabetic emergencies occur during dental visits. Appropriate scheduling and treatment planning can help reduce the incidence of these emergencies. Communicating often with the patient, the patient's physician and other professionals involved in diabetes management can be reassuring to both patient and practitioner. A clear understanding of the patient's current therapeutic regimen and blood glucose level will allow the dental practitioner to respond quickly and accurately in an emergency situation.
Ultimately it is the responsibility of the patient to manage their diabetes. Dental professionals, who are knowledgeable about potential risk factors, complications and treatment modalities, are a valuable resource to the patient and the community.
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