Sunday, February 1, 2009

Clinical features of type 2 diabetes mellitus

In clinical practice, history, examination and investigations are important to diagnose the disease. History and examinations are the fundamental things and they give evidence of the condition.

Most patients with type 2 diabetes mellitus are asymptomatic for years. Classic symptoms are polyuria, polydipsia, polyphagia and weight loss. Other symptoms that might suggest hyperglycemia include blurred vision, lower extremity paresthesias, or yeast infections, particularly balanitis in men.

The possible presence of diabetes mellitus should be considered in patients with risk factors;
1. obese
2. patients with a first-degree relative with type 2 diabetes mellitus
3. members of high-risk ethnic groups ( black, Hispanic, Native American, Asian American, Pacific Islander) women with a previous delivery of a large infant (>9 lb)
4. a history of gestational diabetes mellitus
5. patients with hypertension
6. Patients with high triglycerides (>250 mg/dL) or low HDL-C (<35 mg/dL).
7. Evidence of polycystic ovary disease

Examination findings
Usually patients with type 2diabetes mellitus present with macrovascular and microvascular complications. Therefore there can be examination findings as well.
1. Evidence of infections (abscesses)
2. skin colour changes
3. parasthesea
4. high blood pressure
5. retinal changes
6. diabetic foot changes

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