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Diabetes Mellitus, Type 2

Samir Malkani, MRCP (UK), MD and Sanaa S. Ayyoub, MD Reviewed 05/2023
 


BASICS

DESCRIPTION

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

Monitor for hypoglycemia; adjust doses fo...

DIAGNOSIS

HISTORY

Polyuria, polydipsia, polyphagia, weight loss, fatigue, blurry vision, neuropathy, and frequent infections. Many individuals are asymptomatic. 

PHYSICAL EXAM

BMI, waist circumference, f...

TREATMENT

Tight glucose control prevents long-term microvascular complications, but benefits on macrovascular outcomes are less apparent. Individuals likely to benefit from a more aggressive target ar...

ONGOING CARE

PATIENT EDUCATION

Diabetes self-management 

PROGNOSIS

Normal lifespan with good management 

COMPLICATIONS

  • ASCVD, peripheral vascular disease, stroke, foot ulcers, Charcot joints

  • Microvascular: ...

REFERENCES

1
American Diabetes Association. Standards of medical care in diabetes. Diabetes Care. 2022;45:S1–S264.
2
Qaseem A, Wilt TJ, Kansagara D, et al. Clinical Guidelines Committee of the American C...

SEE ALSO

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

  • Algorithms: Type 2 Diabetes, Treatment; Weight Loss, Treatment

CODES

ICD10

  • E11.329 Type 2 diabetes mellitus with mild nonproliferative diabetic retinopathy without macular edema

  • E11.331 Type 2 diabetes mellitus with moderate nonproliferative diabetic retinopathy wi...

CLINICAL PEARLS

  • Individualize A1c targets based on life expectancy and comorbidities.

  • Hypoglycemia poses more short-term danger than hyperglycemia.

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