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Gestational Diabetes Dental — MFDS Part 1 MCQ

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ModerateHuman DiseaseGestational Diabetes DentalMFDS Part 1

A woman who is 30 weeks pregnant has gestational diabetes treated with rapid-acting insulin before meals. She is booked for non-surgical periodontal treatment under local anaesthesia without sedation. She says she intends to inject her usual pre-breakfast insulin but omit breakfast because she believes dental procedures require fasting. Which is the most appropriate advice?

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

Reveal the answer and explanation

Correct answer: A — Proceed after her usual breakfast and prescribed diabetes regimen, with rapid-acting glucose available

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

A is correct. Routine periodontal treatment under local anaesthesia does not require fasting. Taking rapid-acting insulin and then missing breakfast can precipitate hypoglycaemia, so she should eat normally, follow her prescribed diabetes plan and have rapid-acting glucose available. Fasting while continuing insulin (B) creates an avoidable hypoglycaemia risk. The dentist should not independently advise omission of all insulin for the day (C); any alteration must be agreed with the diabetes team. Necessary dental and periodontal care is not routinely deferred during pregnancy (D). Gestational diabetes alone is not an indication for antibiotic prophylaxis (E). The original explanation was overbroad because metformin, commonly used for gestational diabetes, does not usually cause hypoglycaemia when used alone.

Reference: National Institute for Health and Care Excellence. Diabetes in pregnancy: management from preconception to the postnatal period, NG3, recommendations 1.3.13–1.3.14. Updated 2020. https://www.nice.org.uk/guidance/ng3/chapter/recommendations