Question

Which of the following preoperative instructions are

most appropriate for a well-controlled insulindependent
diabetic patient who is scheduled at 9:00
a.m. for the extraction of two teeth under local
anesthesia?
A. Eat breakfast before the appointment and delay
insulin injection until after the appointment.
B. Take insulin before the appointment and delay
breakfast until after the extractions.
C. Eat breakfast before the appointment and take
insulin according to the regime prescribed by
the physician.
D. Delay breakfast and insulin until after the
dental appointment.

Answer 1

The best preoperative instruction for an insulin-dependent diabetic patient is to eat breakfast and take insulin as prescribed to maintain stable blood glucose levels and avoid complications such as hypoglycemia or hyperglycemia during tooth extraction.

Step-by-step explanation:

The most appropriate preoperative instruction for a well-controlled insulin-dependent diabetic patient scheduled for a tooth extraction at 9:00 a.m. would be to eat breakfast before the appointment and take insulin according to the regimen prescribed by the physician. It is crucial to maintain a balance between food intake and insulin administration to avoid periods of hypoglycemia or hyperglycemia. The instruction to eat breakfast before the appointment ensures that the patient has adequate energy and stable blood glucose levels during the procedure, while taking insulin as prescribed supports the metabolism of this meal and prevents blood glucose spikes.

Insulin injections are meant to allow for the transport and storage of glucose, thereby helping to regulate blood glucose levels. In the setting of oral intake, especially a meal with carbohydrates, insulin helps to lower blood glucose levels to prevent hyperglycemia. Conversely, skipping a meal can lead to hypoglycemia, particularly in patients taking insulin or other blood glucose-lowering medications, which can be a dangerous complication.

It is not recommended to delay insulin or meals in diabetic patients prior to procedures, as this can lead to instability in blood glucose control. The goal is to mimic the normal physiological state as closely as possible, which typically involves eating regular meals and taking insulin as prescribed to ensure glucose levels remain within the target range.