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Pathology
Relative insulin deficit and resistance to insulin action
Aetiology
Genetics + environment (high density food intake, obesity, lack of exercise, chronic pancreatitis, Cushing’s). Peak incidence 50 years
Signs
High BMI, central obesity, acanthosis, foot ulcers, visual defects
Symptoms
May be asymptomatic initially, recurrent infections, polyuria, polydipsia, weight loss, HHS.
Investigations
Bloods: Plasma glucose, serum ketones, U&E, HbA1C
Venous Blood Gas: pH and bicarbonate
Treatment
Lifestyle measures: Diet, exercise, smoking cessation, patient education
Medical: Sulphonylurea, biguanides, glitazones, GLP-1 analogues, and DPP-4
inhibitors, using a stepwise approach.
Surveillance: Regular follow-up and HbA1c to monitor glycaemic control and
complications
Prognosis
Can be life limiting due to 4-fold increase in cardiovascular disease, 10-20 year reduction in life expectancy
Cardiovascular disease, DM retinopathy, DM nephropathy, DM neuropathy, peripheral vascular disease
Key Facts
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Key Images
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Key References
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