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June 29, 1999

Hyperglycemia and DKA

Question from Farmington Hills, Michigan, USA:

My son recently had a tooth pulled and the dentist injected Novocaine into the gum. His blood sugar before the procedure was 245 and afterward, 480! Does Novocaine cause an increase in blood sugar or was it the stress of the procedure?

Answer:

More likely the stress of the procedure, though sometimes some epinephrine is injected along with the novocaine which could have raised the blood sugar slightly.

TGL
Additional Comments from Dr. Frank Varon, DDS

I would agree that the rise in blood sugar could be attributed to exogenous
or endogenous epinephrine from the procedure. I usually refrain from the use of vasoconstrictors (especially epinephrine) in people with Type 1 diabetes in dental procedures because of this very problem: you don’t know the source of the rise in blood sugar. Also there may be normal fluctuations in daily blood sugar in children. Dental procedures are best done on these patients in the morning because they are better able to handle the “stress” of the procedure.

FV