Diabetes mellitus

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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:

Gastrointestinal pathology

Breast pathology

Genitourinary pathology

Placental pathology

Cardiovascular pathology

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

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