EARLY WARNING SIGNS OF IMPENDING HYPOGLYCEMIA MASKED BY POSTEXTRACTION LABIAL PARESTHESIA

Temporary lingual and labial paraesthesia are not uncommon following t he removal of mandibular third molar teeth. in patients with insulin-t reated diabetes circum-oral paraesthesia is a common and important sig n of impending hypoglycaemia. This report highlights the case of a 17- year-old girl with Type 1 (insulin-dependent) diabetes who, following the extraction of her four wisdom teeth, experienced minor circum-oral sensory disturbances. These effectively masked her early warning sign s of impending hypoglycaemia which had hitherto allowed her to have ve ry good glycaemic control. Trembling, sweating and loss of concentrati on became the new presenting symptom complex, which she found both dis abling and worrying. Fortunately, within six months the paraesthesia h ad subsided and the patient was once again able to appreciate her usua l warning symptom of impending hypoglycaemia.