Foundations in Continuing Education

The Dental Patient with Diabetes

Chapter Six - Pre Diabetes: Impaired Glucose Homeostasis


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 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

Chapter 14: Prevention and Treatment of DM

Chapter 15: Diabetes Medications

Chapter 16: Conclusion

Glossary

Appendices

References

Post Examination

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The two separate categories of impaired glucose homeostasis (impaired glucose metabolism) are impaired fasting glucose (IFG) and impaired glucose tolerance (IGT). It is important to note that IGT and IFG are now termed pre diabetes and are considered risk factors for the potential onset of diabetes.

These categories (See Table 3) designate blood glucose levels between "normal" and diabetic. Persons with impaired glucose homeostasis are at risk for developing diabetes. (Fasting Plasma Glucose (FPG) test is described here.

Table3: Impaired Glucose Homeostasis (19,48)

Category
Level
Normal Fasting Glucose FPG < 100 mg/dL
Impaired Fasting Glucose FPG Greater than or Equal to 100 and < 126 mg/dL
Impaired Glucose Tolerance after OGTT FPG Greater than or Equal to 140 but < 200mg/dL

The current upper limit of normal is a fasting glucose concentration of 100mg/dL. IFG occurs when fasting plasma glucose (FPG) is Greater than or Equal to 100 mg/dL but < 126 mg/dL.

IGT is Greater than or Equal to 140 but < 200 mg/dL (results of the oral glucose tolerance test in the two hour sample).

The cutoff point for "normal" at 100 mg/dL is due to the belief that microvascular complications arise at this blood glucose level. Researchers suggest that by separating individuals at the 100 mg/dL point might prevent later complications. (19)

Continue on to Chapter 7: Other Specific Types of Diabetes