Diabetes mellitus: symptoms, indications of glucose measurement, general aspects of treatment

1. Big picture

Diabetes mellitus is clinically important because the patient may present in three different ways: 1) classic hyperglycemic symptoms, 2) acute emergency such as hypoglycemia, diabetic ketoacidosis, or hyperosmolar state, or 3) chronic complications such as nephropathy, retinopathy, neuropathy, myocardial infarction, stroke, or peripheral arterial disease.

For the exam, think in this order:

Hyperglycemia → renal glucose threshold exceeded → glucosuria → osmotic diuresis → polyuria → dehydration/thirst → polydipsia → calorie loss → polyphagia + weight loss.

The current diagnostic framework still relies on venous plasma glucose or HbA1c: fasting pla