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Diabetes Mellitus, Type 2

Sanaa Ayyoub, MD and Samir Malkani, MD, MRCP—UK Reviewed 06/2019
 


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

Tight control of type 2 diabetes prevents long-term microvascular complications, but benefits on macrovascular outcomes are not as apparent (2). Individuals likely to benefit from a more agg...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

A1c twice a year for patients with well-controlled blood glucose and quarterly for patients with hyperglycemia or recent changes in therapy 

PATIENT EDUCATION

REFERENCES

1
American Diabetes Association. Standards of medical care. Diabetes Care.  2019;42(Suppl 1):S1–S193. [View Abstract on OvidMedline]
2
Davies MJ, D’Alessio DA, Fradkin J, et al. Managemen...

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 poses more short-term dange...

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