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The manifestations of diabetes mellitus from a clinical perspective. (WC/Mikael Häggström)

Diabetes mellitus, often just diabetes, is a common affliction that is increasing with the expanding waistlines. It is commonly abbreviated DM.

General

Major cardiovascular risk factor.
Many subtypes.
- Most common: DM type 2 -- strongly associated with obesity.

Diagnosis

Based on biochemistry, specifically:

Fasting blood glucose >=7.0 mmol/L.
Two-hour glucose tolerance test >=11.1 mmol/L.

Classic complications

Family medicine - mnemonic HELP:

H - HbA1c, hypertension.
E - eye.
L - lipids.
P - podiatry, proteinuria, Pneumococcus vaccine.

Emergency room presentations

Ketoacidosis - DM type 1.
Hyperosmotic non-ketotic (HONK) coma - DM type 2.

Subspecialty specific findings

Dermatopathology

Other:

Fibroepithelial polyp.

Gastrointestinal pathology

Microscopic colitis - generally assoc. with autoimmune disorders.
Pancreatic amyloid deposition - in DM type 2.^[1]
Centrilobular macrovescicular steatosis of the liver.
Pancreatic islet cell hyperplasia - in the fetus of a mother with diabetes.

Breast pathology

Diabetic mastopathy.

Genitourinary pathology

Placental pathology

Cardiovascular pathology

Atherosclerosis.
Arterial hyaline - in both afferent and efferent arteriole of the kidney.

Neuropathology

Idiopathic inflammatory myositis.^[4]

Forensic pathology

Diabetic coma (preceding death) at autopsy - may be demonstrated with an elevated glucose in the vitreous fluid.^[5]

References

↑ URL: http://www.umm.edu/altmed/articles/amyloidosis-000007.htm. Accessed on: 23 October 2010.
↑ Amer HZ, Heller DS (2010). "Chorangioma and related vascular lesions of the placenta--a review". Fetal Pediatr Pathol 29 (4): 199–206. doi:10.3109/15513815.2010.487009. PMID 20594143.
↑ Lilja M (July 1994). "Infants with single umbilical artery studied in a national registry. 3: A case control study of risk factors". Paediatr Perinat Epidemiol 8 (3): 325–33. PMID 7997408.
↑ Limaye VS, Lester S, Blumbergs P, Roberts-Thomson PJ (May 2010). "Idiopathic inflammatory myositis is associated with a high incidence of hypertension and diabetes mellitus". Int J Rheum Dis 13 (2): 132–7. doi:10.1111/j.1756-185X.2010.01470.x. PMID 20536597.
↑ Zilg, B.; Alkass, K.; Berg, S.; Druid, H. (Mar 2009). "Postmortem identification of hyperglycemia.". Forensic Sci Int 185 (1-3): 89-95. doi:10.1016/j.forsciint.2008.12.017. PMID 19167848.

[1] URL: http://www.umm.edu/altmed/articles/amyloidosis-000007.htm. Accessed on: 23 October 2010.

[pmid20594143-2] Amer HZ, Heller DS (2010). "Chorangioma and related vascular lesions of the placenta--a review". Fetal Pediatr Pathol 29 (4): 199–206. doi:10.3109/15513815.2010.487009. PMID 20594143.

[pmid7997408-3] Lilja M (July 1994). "Infants with single umbilical artery studied in a national registry. 3: A case control study of risk factors". Paediatr Perinat Epidemiol 8 (3): 325–33. PMID 7997408.

[pmid20536597-4] Limaye VS, Lester S, Blumbergs P, Roberts-Thomson PJ (May 2010). "Idiopathic inflammatory myositis is associated with a high incidence of hypertension and diabetes mellitus". Int J Rheum Dis 13 (2): 132–7. doi:10.1111/j.1756-185X.2010.01470.x. PMID 20536597.

[pmid19167848-5] Zilg, B.; Alkass, K.; Berg, S.; Druid, H. (Mar 2009). "Postmortem identification of hyperglycemia.". Forensic Sci Int 185 (1-3): 89-95. doi:10.1016/j.forsciint.2008.12.017. PMID 19167848.

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Diabetes mellitus

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