Fast Five Quiz: Type 2 Diabetes Presentation and Diagnosis

Romesh Khardori, MD, PhD

Disclosures

January 21, 2022

Figure 1. Insulin resistance.

Unlike the sudden and symptomatic onset of type 1 diabetes, type 2 diabetes has a gradual and asymptomatic onset. It is this asymptomatic nature of early type 2 diabetes that creates a diagnostic challenge for clinicians — one that underscores the importance of obtaining a thorough patient history to identify at-risk patients. Patients with type 2 diabetes may present with acanthosis nigricans and/or hirsutism in conjunction with thick necks and chubby cheeks. This can help to differentiate type 2 diabetes from type 1 diabetes.

Patients with type 2 diabetes may also present with increased thirst and urination. Some patients also experience numbness or tingling in their hands or feet or have blurred vision.

At the onset of type 2 diabetes, patients tend not to have symptoms of hyperglycemia and hypoglycemia.

Most patients with type 2 diabetes are overweight or obese (body mass index [BMI] ≥ 30 or weight > 120% of desirable body weight) at presentation, older than 45 years, and not lean in physique. A subset of patients, however, have lean diabetes (a low or normal BMI of < 22).

Learn more about the presentation of type 2 diabetes.

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