Metformin Dental Sedation — ORE Part 1 MCQ

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EasyHuman Disease & Dental ManagementMetformin Dental SedationORE Part 1

A patient with type 2 diabetes controlled with metformin alone is scheduled for routine dental treatment under IV conscious sedation. There is no planned general anaesthetic, iodinated contrast administration, renal impairment or acute illness. What should be done with their metformin on the day of treatment?

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Reveal the answer and explanation

Correct answer: E — Continue the usual metformin dose

Explanation lettering: D = shown as A · E = shown as B · B = shown as C · C = shown as D · A = shown as E

The correct answer is A: continue the usual metformin dose. For dental IV conscious sedation, UK NHS instructions advise patients to take routine medication at the normal time; diabetes-related fasting advice should be individualised. Metformin alone does not usually cause hypoglycaemia. The 48-hour interruption rule is associated with elective surgery under general, spinal or epidural anaesthesia, and with relevant iodinated-contrast procedures—not routine dental conscious sedation. Therefore B and C apply an inappropriate or arbitrary interruption. D is unsafe because diabetes medicines must not be empirically increased. E is inappropriate because temporary conversion to insulin requires a separate diabetes-management plan and is not indicated for this procedure.

Reference: Liverpool University Dental Hospital. Patients having dental treatment under intravenous conscious sedation, Medication section: take routine medication at the normal time. Current NHS patient information. https://www.uhliverpool.nhs.uk/patients-and-visitors/patient-leaflets/patients-having-dental-treatment-under-intravenous-conscious-sedation-pif-638pdf