I would like to comment on the use of the phrase ‘well controlled' when describing medical conditions and taking a medical history. This non-definable term is seemingly popular currently within the dental profession. My specific issue relates to its use in relation to diabetes; however, it is relevant to other medical conditions. The term ‘well controlled' is subjective. It does not have a definition. There is a proposed lack of awareness of those with diabetes understanding their Hba1c readings.1 Therefore, concluding that diabetes is ‘well controlled' without ascertaining the patient's perception of what this means, our own professional perception of what this means, or using measurable parameters, may lead to errors and is an inaccurate way to establish the status of the condition.

It is advised we should not ask patients with diabetes what their control is like.2 Asking this could give the perception that the clinician's sole focus is diabetes and glucose levels rather than a person living with diabetes. Furthermore, many factors can affect glucose levels outside of patient control, such as sickness, exercise, stress, temperature, glycaemic index and more. Assuming that diabetes can be controlled could create the perception of a clinician who ignores the many variables and the effort required by people with diabetes to manage the condition all day, every day. Having a patient declare they are poor in their management despite their best efforts could be disheartening and be interpreted as insensitive. I wonder if our current methods in taking a medical history for diabetes could result in a breakdown in rapport and patient engagement.

As dental professionals, it is our duty to ask questions in a non-judgemental manner and take an accurate medical history. When describing caries we have progressed from phrases such as ‘gross' to ‘extensive' and from ‘poor' oral hygiene to ‘suboptimal'. The same concept should be applied to medical conditions. As professionals, how can we declare a medical history is accurate, without asking appropriate questions? To record a patient's diabetes status, there needs to be objective evidence to reach such conclusion. Suggested questions: What is your HbA1c?/What are your daily glucose readings? How many episodes of hypoglycaemia or hyperglycaemia do you experience daily/weekly? What time of day do you experience these events?

With advancing technology, there are easier ways to determine the status of patients' diabetes. Continuous glucose monitoring devices, for example the Libre and Dexcom, are increasing in popularity. These devices often link directly to the patient's phone. They can display graphs showing the patient's glucose management, which can be viewed over varying periods of time. Asking the patient if they use the Libre or Dexcom may make understanding glucose management easier for patient and dental professional.