Diabetic ASA Classification — NDEB AFK MCQ

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ModerateMedical Emergencies in DentistryDiabetic ASA ClassificationNDEB AFK

A patient with type 1 diabetes mellitus who takes insulin glargine (long-acting) and insulin lispro (rapid-acting) before meals is classified as which ASA physical status?

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Correct answer: A — ASA III (if well-controlled) or ASA IV (if poorly controlled)

A type 1 diabetic patient on insulin therapy is classified as at least ASA II (well-controlled, HbA1c <64 mmol/mol, no complications) to ASA III (poorly controlled, HbA1c >75 mmol/mol, or with end-organ complications such as nephropathy, retinopathy, neuropathy, cardiovascular disease). Insulin-dependent diabetes always carries a risk of hypoglycaemia during dental procedures — morning appointments after breakfast and insulin are recommended. The dental team should have oral glucose and glucagon available.

Reference: Malamed – Medical Emergencies in the Dental Office, 8th ed., 2022