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 plasma glucose, random plasma glucose with symptoms, oral glucose tolerance test, or HbA1c. ADA 2026 standards also emphasize individualized therapy, avoidance of hypoglycemia, cardiovascular/renal risk reduction, and patient-centered drug choice. ([Diabetes Journals][1])

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