Titanium Fixation in Oral and Maxillofacial Surgery

Although the consensus is that near normal blood glucose is optimal for all persons with type 1 and type 2 diabetes, the means to this end is controversial. The Diabetes Control and Complications Trial, The United Kingdom Prospective Diabetes Study, and the Kumamoto Trial, all clearly showed that when normoglycemia is achieved and maintained for over 6 years, there is a decreased risk of retinopathy, neuropathy, nephropathy and cardiovascular disease. However, when attempts to achieve this decree of glucose control are made the risks associated with intensive insulin delivery include hypoglycemia and weight gain. However, newer insulins, medications and technologies have allowed for improved glucose control and minimized the risks. This talk will review the evidence that improved glucose control decreases the risk of diabetes related complications and will suggest treatment algorithms that facilitate normoglycemia in both type 1 and type 2 diabetes. Objectives: ● Understand the rationale for normalization of blood glucose levels in type 1 and type 2 diabetic patients ● Have the skills to achieve and maintain normoglycemia in patients using all types of insulin pumps or using multiple injections of a combination of long-acting insulin analogues together with rapid-acting insulin analogues ● Make adjustments in the insulin doses for the changes in ones life (exercise, illness, growth and development, etc.) ● Teach the principles to the patients to help him/ her to continuously adjust their does to fit their individual lifestyle and activities ● Change the doses of insulin for unusual life circumstances, along with the addition of medications (steroids, thiazides, immunosuppressive agents) that impact on glucose control ● Utilize the data derived from the profiles obtained using continuous glucose monitoring to make treatment decisions ● Prescribe a meal plan to patients with diabetes who have not seen a dietitian and who are awaiting personalized meal planning ● Understand the economic and social barriers that impact on success ● Understand the new developments in technology, transplantation, and incretins in the total picture of achieving and maintaining normoglycemia