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Type 1 Diabetes Pre-Op Glucose — ORE Part 1 MCQ

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ModerateHuman Disease & Dental ManagementType 1 Diabetes Pre-Op GlucoseORE Part 1

A 50-year-old patient with type 1 diabetes managed with an insulin pump is booked for a surgical dental extraction at 10:00 am. They ate breakfast at 7:00 am and have no symptoms of hypoglycaemia. At 9:30 am, a finger-prick blood glucose measurement is 5.5 mmol/L. What is the most appropriate concern before starting treatment?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — A fall in glucose during treatment is possible, so rapid-acting carbohydrate should be available

**A is correct.** A reading of 5.5 mmol/L is not hypoglycaemia: UK NHS advice generally defines a hypo as blood glucose below 4 mmol/L. It should therefore not automatically trigger cancellation or immediate glucose treatment in an asymptomatic patient. However, a patient with type 1 diabetes receiving insulin via a pump may develop hypoglycaemia if food intake is delayed or insufficient relative to insulin. Before a surgical extraction, the dental team should be alert to that possibility, monitor appropriately and have rapid-acting carbohydrate available for a conscious patient. **B** is wrong because 5.5 mmol/L is not high. **C** is wrong because the diagnostic threshold for hypoglycaemia has not been reached. **D** is unsafe because a normal pre-operative value does not eliminate risk. **E** is wrong because pump management is individualised and a pump is not routinely disconnected for a simple dental extraction.

Reference: NHS, Low blood sugar (hypoglycaemia), updated 2023, https://www.nhs.uk/conditions/low-blood-sugar-hypoglycaemia/