Diabetes Mellitus, Type 2

Swathi A.N. Rao, MD, Sathya S. Krishnasamy, MD and Jeremy Golding, MD, FAAFP Reviewed 06/2018
 


BASICS

DESCRIPTION

Diabetes mellitus (DM) type 2 is due to a progressive insulin secretory defect in the setting of insulin resistance. 
Geriatric Considerations

Monitor elderly for hypoglycemia; adjust ...

DIAGNOSIS

HISTORY

Polyuria, polydipsia, polyphagia, weight loss, weakness, fatigue, blurry vision, neuropathy, and frequent infections 

PHYSICAL EXAM

BMI, funduscopic exam, oral exam, cardiopulmonary exa...

TREATMENT

It is uncertain as to whether and to what extent tight control of Type 2 diabetes prevents long-term macro- and microvascular complications (2),(3)[A]. Individuals most likely to benefit fro...

ONGOING CARE

FOLLOW UP RECOMMENDATIONS

Patient Monitoring

  • Monitor glucose, HbA1c, BP, body weight, lipid profile, and renal and liver function q 3mo at first.

  • A1c twice a year for patients with well-cont...

REFERENCES

1 American Diabetes Association. Standards of medical care in diabetes—2017. Diabetes Care.  2017;40(Suppl 1):S1–S135.
2 Shaughnessy AF, Erlich DR, Slawson DC, et al. Type 2 diabetes:...

SEE ALSO

  • Diabetes Mellitus, Type 1; Diabetic Ketoacidosis; Hypertension, Essential

  • Algorithm: Type 2 Diabetes, Treatment

CODES

ICD10

  • E11.9 Type 2 diabetes mellitus without complications

  • E11.319 Type 2 diabetes mellitus with unspecified diabetic retinopathy without macular edema

  • E11.21 Type 2 diabetes mellitus with nephropa...

CLINICAL PEARLS

Individualize A1c targets based on life expectancy, preexisting DM complications, comorbidities and individual patient preferences and values. Hypoglycemia is much more dangerous than ...

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