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Diabetes mellitus type 2
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Diabetes mellitus type 2

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Contributors: David Brodell MD, Paritosh Prasad MD, Lowell A. Goldsmith MD, MPH
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Synopsis

Type 2 diabetes (T2DM) is characterized by hyperglycemia secondary to increased insulin resistance, inadequate production of insulin to meet metabolic demand, increased hepatic glucose production, and atypical fat metabolism. In T2DM, insulin resistance may be rooted in genetics and obesity. Initially, insulin secretion increases to compensate for worsening insulin resistance. But over time, increased insulin production cannot compensate for insulin resistance.

Patients may initially present with symptoms of hyperglycemia such as blurred vision, vulvovaginitis, pruritus, and peripheral neuropathy, as well as recurrent yeast infections. If insulin deficiency is more severe, fatigue / weakness, polyuria, polydipsia, and sometimes weight loss may present as symptoms. Diabetic ketoacidosis is rare. Some patients are relatively asymptomatic until chronic complications of diabetes develop. Prior to the initial diagnosis, all patients develop impaired glucose tolerance or impaired fasting glucose.

T2DM is commonly associated with obesity, including childhood obesity, increased waist circumference, cardiovascular disease, end-stage renal disease, adult blindness, and nontraumatic lower extremity amputations, among other problems.

T2DM has a strong genetic component and tends to disproportionately affect older populations, individuals with a high body mass index (BMI), and individuals of African, Hispanic, American Indian, and Asian descent.
 
For more information, see OMIM.

Related topics: Diabetes mellitus type 1, Diabetic retinopathy, Diabetic dermopathy, Diabetic nephropathy, Diabetic neuropathy, Diabetic hyperosmolar syndrome, Neurogenic ulcer, Bullosis diabeticorum

Codes

ICD10CM:
E11.9 – Type 2 diabetes mellitus without complications

SNOMEDCT:
44054006 –  Diabetes mellitus type 2

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

Best Tests

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Management Pearls

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Therapy

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Drug Reaction Data

Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.

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References

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Last Reviewed: 01/24/2017
Last Updated: 10/18/2018
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Diabetes mellitus type 2
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Diabetes mellitus type 2 : Fatigue, Hyperglycemia, Neuropathy peripheral, Polyuria, Polydipsia
Copyright © 2018 VisualDx®. All rights reserved.