Fast Five Quiz: Type 2 Diabetes Mellitus Presentation and Diagnosis

Romesh Khardori, MD, PhD


January 30, 2020

Figure 1. Insulin resistance.

Patients with type 2 DM typically do not receive the diagnosis until several years after disease onset. Although recent data are lacking, older studies estimate patients with type 2 DM live with the disease approximately 4-7 years prior to its diagnosis. Unlike the sudden and symptomatic onset of type 1 DM, type 2 DM has a gradual and asymptomatic onset. It is this asymptomatic nature of early type 2 DM that creates a diagnostic challenge for clinicians—one that underscores the importance of obtaining a thorough patient history to identify at-risk patients.

As previously noted, at the onset of type 2 DM, patients tend not to have symptoms of high and low blood glucose levels until later in the progression of the disease.

Most patients with type 2 DM are overweight or obese at presentation (body mass index [BMI] ≥ 30 kg/m2 or weight > 120% of desirable body weight), older than 45 years, and not lean in physique. A subset of patients, however, have lean diabetes (a low or normal BMI of < 25 kg/m2).

Learn more about the presentation of type 2 DM.


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