Sunday, February 1, 2009

Clinical presentation of diabetes mellitus

There are four ways of presentations;

  1. asymptomatic( incidental finding)
  2. presentation with acute symptoms
  3. subacute presentation
  4. presentation with complications

Asymptomatic presentation

This is the commonest presentation and it is an incidental finding during routine examination or medical examination for insurance/ license/ employment

There is no evidence of ill health

Elevated blood sugar level could be a finding at those routine examinations. There can be glucose in the urine as well, even though it is a clue of hyperglycemia, not diagnostic

Further investigations should be done

Acute presentation

Usually these patients present with classic triad of symptoms;

  1. polyuria
  2. polydipsia
  3. weight loss

They have a brief history (2-6 weeks)

Usually patients with type 2 diabetes present like this

Subacute presentation

These patients have symptoms over a period of months or years. Common symptoms are polyuria, polydipsia, and weight loss.

They can also present with non-specific symptoms such as:

  1. lack of energy
  2. visual blurring
  3. pruritus vulvae
  4. balanitis

This is the usual presentation of type 2 diabetes mellitus.

Presentation with complications

Types of complications are;

1. microvascular
2. macrovascular
3. others

Microvascular complications;

1. nephropathy
2. neuropathy
3. retinopathy

Macrovascular complications;

1. Ischemic heart disease
2. stroke
3. peripheral vascular disease


1. staphylococcal skin infections (furuncles, carbuncles, abscesses)
2. wound infections
3. fungal infections

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