Acute complications. Hypoglycemia is the major issue
that confronts dental practitioners when treating diabetic
patients, particularly if patients are fasting (4). The
clinical presentation of hypoglycemia is very similar
to hyperglycemia. If in doubt, it should be treated as a
hypoglycemia. The characteristics and treatment of this
complication are showed in Table 2 (4).
Hypoglycemia usually appears in response to the stress
experienced before, during or after the treatment, and has
been shown to cause a significant increase in perioperative
morbidity and mortality (1). The stress response is
characterized by acute metabolization of carbohydrates,
proteins and fats to provide increased levels of glucose,
which is necessary as a major fuel source to the vital
organs. In addition, resistance to the effects of insulin
increase (1). There are no specific guidelines regarding
which levels of hyperglycemia are dangerous or how it
should be managed before or during the procedure, so
if the patient is conscious and can follow other instructions,
it is prudent to continue with the treatment (4).