Treatment of patients who have type 1 diabetes mellitus: physiological misconceptions and infusion pump therapy.
BACKGROUND
This article reviews the unique physiology of patients who have type 1 diabetes mellitus (insulin-dependent diabetes mellitus, or IDDM); allays some common physiological misconceptions; and updates dental practitioners on the emerging technology of insulin infusion pump therapy, now available to patients who have type 1 diabetes mellitus.


METHODS
The authors review the physiology of stress and describe the dawn phenomenon. They also describe insulin infusion pump therapy, as well as its advantages and disadvantages, to familiarize dentists with new technologies in caring for patients who have diabetes. Emergencies that may present themselves as a result of these advances in biotechnology are discussed.


CONCLUSIONS
Dental practitioners who treat patients who have IDDM need to have a solid foundation in the basic medical sciences and emerging biomedical technology as they each relate to diabetes. Practitioners must become familiar with infusion pump therapy, not only for cases of medical emergencies, but also to customize treatment for patients who have diabetes. Practitioners also need to remain up to date in the rapidly changing realm of caring for people who have diabetes.
Nova Southeastern University College of Dental Medicine, Fort Lauderdale, Fla., USA. jrkeene7@aol.com
John R
JR
Keene
Steven I
SI
Kaltman
Howard M
HM
Kaplan
D000208:Acute Disease; D002940:Circadian Rhythm; D016854:Dental Anxiety / Q000150:complications / Q000209:etiology; D017742:Dental Care for Chronically Ill / Q000009:adverse effects; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology*; D004435:Eating; D004638:Emergency Treatment; D006801:Humans; D006943:Hyperglycemia / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D007003:Hypoglycemia / Q000175:diagnosis / Q000209:etiology; D015918:Infusion Pumps, Implantable; D007332:Insulin Infusion Systems