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Content on this page:
Overview
Diabetes mellitus is a heterogenous metabolic disease that
is defined in the Introduction
section.
The Epidemiology
section gives a detailed discussion on the cases affected by diabetes mellitus regionally
and worldwide.
Genetic and environmental factors that cause diabetes
mellitus are found in the Etiology
section. Insulin secretion defects and effects are discussed in the Pathophysiology section.
Diabetes mellitus can be classified as type 1,
type 2, gestational, and other specific types. These different types of
diabetes mellitus are described in the Classification
section.
History and Physical Examination
Patients with diabetes mellitus present with classic signs and symptoms that are specific to the type of diabetes the patient has. The Clinical Presentation and Physical examination sections enumerate these signs and symptoms. In the History section, the essential information that needs to be elicited from the patient to come up with the proper diagnosis and management are mentioned.
Diagnosis
Parameters to be considered in the diagnosis of diabetes
mellitus are in the Diagnosis or Diagnostic
Criteria section. The
need for laboratory tests included in these parameters such as HbA1c level and
2-hour plasma glucose measurement are included in the discussion.
All adults who are overweight (body mass index of ≥23 kg/m2
for Asians) or with a waist circumference of ≥80 cm for Asian women and ≥90 cm
for Asian men should be screened for diabetes mellitus especially with some of
the risk factors mentioned in the Screening section.
The Laboratory Tests and
Ancillaries section enumerates the tests that can be performed
in assessing and evaluating the effect of the disease on the patient.
Other diseases that can cause persistent hyperglycemia and
should be ruled out are listed in the Differential
Diagnosis section.
Management
The overall target of the management for diabetes mellitus
is to improve the quality of life and prevent complications and early death. In
the Principles of Therapy
section, the goals and factors to consider in choosing treatment in patients
with diabetes mellitus is discussed.
Drugs that can be considered in the management of diabetes
mellitus such as biguanides, glucagon-like peptide-1 (GLP-1) receptor agonists,
sulfonylureas or insulin secretagogues, etc, and their effect in lowering HbA1c
are enumerated and discussed in the Pharmacological
Therapy section.
Lifestyle modification strategies, patient education and
psychological therapies are essential parts of the management of patients with
diabetes mellitus and are elaborated in the Nonpharmacological
section.
Assessment of glycemic control is essential in evaluating
the effects of therapy given to the patient and the Monitoring section explains these methods
and the glycemic goals.
The Complications
section enumerates the effects of poor glycemic control in patients with
diabetes mellitus. The section also discusses in detail the management of each
complication.
