Medical Emergencies · patient case question
Which HbA1c range represents POORLY controlled diabetes?
Patient case: Medically complex patient presenting with erosion and lethargy
Patient: Male, 58 years old
Chief Complaint: Sensitive upper front teeth and a persistent sour taste.
Background: Type 2 diabetes. Long-standing reflux symptoms, worse at night. Recently referred to a nephrologist.
Current Findings: Cupped, smooth erosive lesions on the palatal surfaces of the maxillary anterior teeth. He appears lethargic, describes low mood and slowed thinking, and has a fine white crystalline deposit visible on the skin of his face, trunk and limbs.
Laboratory: HbA1c 8.2%
Show answer and explanation
Correct answer: A. 8.0–8.5%
- A. CORRECT. The general glycaemic target for most non-pregnant adults is an HbA1c below 7%. A value of 8.0–8.5% corresponds to an average blood glucose of roughly 183–197 mg/dL and represents poor control, with the associated impairment of neutrophil function, delayed wound healing and heightened infection risk that matter for surgical dentistry.
- B. 6.0–6.5% falls in the PREDIABETES band (5.7–6.4%), with 6.5% being the diagnostic threshold for diabetes.
- C. 5.0–5.5% is a NORMAL, non-diabetic value (normal range is below 5.7%).
- D. 7.0–7.5% is at or just above target — imperfect control, but not the answer when a clearly poor value is offered.
Note: Carry the landmarks: <5.7% normal · 5.7–6.4% prediabetes · ≥6.5% diagnostic of diabetes · <7% the usual treatment target · ≥8% poor control. Routine dentistry proceeds; defer elective surgery and consult the physician when control is poor.
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