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Glucometers have made testing blood sugar levels quick and easy. However, it is not a substitute for blood testing in a medical laboratory and is not approved by the American Diabetes Association as a diagnostic tool. It can be helpful when patients are scheduled for long procedures and as a way of evaluating patients’ management of their disease. The glucometer is a means of quick self-testing for glucose levels throughout the day and can be a helpful tool in the dental office. Patients with glucometers should bring them to their appointments since using the glucometer can help avoid an emergency low blood sugar reaction in the chair.
For patients with type 2 diabetes, blood sugar levels can be normal in the morning due to fasting and then climb throughout the day. Glucometers can show normal results, depending on the time of day. Patients who answer positively to questions about excessive thirst, frequent urination, excessive hunger, or recent changes in vision should be referred to their physician for evaluation. Normal glucose readings are between 70 and 100 milligrams-/deciliter (mg/dl). Nonfasting levels over 200 mg/dl or fasting levels over 125 mg/dl should be an indication for referral.
Patients who take insulin are at greatest risk for hypoglycemic incidents. When scheduled for procedures of 45 minutes to an hour or more, a glucometer reading should be taken at baseline, and when the reading is low the patient should be given 15 mg of carbohydrate (4 to 6 ounces of juice, with grape juice having the highest concentration of glucose; apple the lowest). This amount of carbohydrate will raise the level of glucose by 30 g or 50 mg/dl. This protocol is appropriate for any dental or hygiene procedure, including scaling and root planing.
(Source: Dimensions of Dental Hygiene, September 2007)
