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November 12, 2006

Other

Question from Clayton, North Carolina, USA:

My 11 year old daughter has type 1 diabetes and uses an insulin pump. We just found out this week that she needs to have oral surgery to remove a cyst in her gums. We are meeting with the surgeon in the next few days. What should we know about how this will affect her diabetes and blood sugars before we meet with the surgeon? Do you think she will need to be in the hospital, as a precaution, the night of the surgery?

Answer:

Cysts are sometimes found associated with unerupted teeth or other pathologies but have a very high probability of being found benign. At your daughter’s age, I would suspect generally it might be associated with a tooth. The surgeon needs to know what are her recent A1c levels and a list of any other medications that she takes and a thorough health history. Under no circumstances should the insulin pump be removed during routine oral surgery and if your daughter is to be sedated, this should be done in a hospital environment and after consultation with her physician and/or diabetes educator. It is very possible that the oral surgeon could utilize gas to keep her comfortable and lessen her awareness of the procedure. It depends largely on what type of cyst is present. Afterwards, please be aware, depending on her pain levels, this will affect her ability to eat and insulin might have to be adjusted depending on the glucose levels. The rule of thumb in my practice is to keep it minimally invasive and simple and the patient experience should be short and quick with minimal post-operative care.

If you learn about what type of cyst they are evaluating, I could provide you further information.

FV