Type 2 Diabetes Mellitus: High-Yield Notes
Type 2 diabetes mellitus is characterized by insulin resistance with relative insulin deficiency, and many patients are asymptomatic early and chronic hyperglycemia leads to microvascular and macrovascular complications.
Classic Symptoms
- Polyuria: frequent urination
- Polydipsia: increased thirst
- Polyphagia: increased hunger
- Fatigue and blurred vision may also occur
- Many patients are diagnosed during routine screening
Metabolic Features
- Central obesity is common
- Insulin resistance is the major underlying problem
- Metabolic syndrome often coexists
- Hypertension and dyslipidemia are frequently present
Skin Clues
- Acanthosis nigricans at neck and axilla suggests insulin resistance
- Skin tags may be present
- Recurrent skin infections can occur in poorly controlled disease
Microvascular Complications
- Retinopathy: blurred vision, retinal damage in long-standing disease
- Nephropathy: microalbuminuria is an early sign; may progress to CKD
- Neuropathy: tingling, numbness, burning feet; stocking-glove pattern is typical
Foot and Wound Problems
- Poor wound healing is common
- Neuropathy predisposes to unnoticed trauma
- Ischemia plus neuropathy increases risk of diabetic foot ulcers
- Foot care is very important in long-standing diabetes
Cardiovascular Risk
- Markedly increased risk of atherosclerotic cardiovascular disease
- MI and stroke are major causes of morbidity and mortality
- Hypertension and dyslipidemia worsen risk further
Diagnostic Clues
- Fasting plasma glucose ≥126 mg/dL is diagnostic
- HbA1c ≥6.5% is diagnostic
- Random plasma glucose ≥200 mg/dL with classic symptoms is also diagnostic
- Oral glucose tolerance testing can also diagnose diabetes
Medical disclaimer:
This is for education only and not a substitute for medical diagnosis or treatment.
From: Paul S. Dangha.MLT (AMT), Pt(ASCP), BSc Microbiology.
University of Arkansas, Little Rock. USA.
