Type 2 diabetes mellitus (T2DM) is characterized by hyperglycemia secondary to increased insulin resistance, inadequate production of insulin to meet metabolic demand, increased hepatic glucose production, and atypical fat metabolism. In T2DM, insulin resistance may be rooted in genetics and obesity. Initially, insulin secretion increases to compensate for worsening insulin resistance. But over time, increased insulin production cannot compensate for insulin resistance.
Patients may initially present with symptoms of hyperglycemia such as blurred vision, vulvovaginitis, pruritus, and peripheral neuropathy, as well as recurrent yeast infections. If insulin deficiency is more severe, fatigue / weakness, polyuria, polydipsia, and sometimes weight loss may present as symptoms. Diabetic ketoacidosis is rare. Some patients are relatively asymptomatic until chronic complications of diabetes develop. Prior to the initial diagnosis, all patients develop impaired glucose tolerance or impaired fasting glucose.
T2DM is commonly associated with obesity, including childhood obesity, increased waist circumference, cardiovascular disease, end-stage renal disease, adult blindness, and nontraumatic lower extremity amputations, among other problems. Onset in youth is associated with a progressive increase in risk of complications over time, including microvascular complications. T2DM of more than 10 years' duration may increase the risk of dementia.
T2DM has a strong genetic component and tends to disproportionately affect older populations, individuals with a high body mass index (BMI), and individuals of African, Hispanic, American Indian, and Asian descent.
A large review of US Department of Veterans Affairs patient records suggests that individuals infected with SARS-CoV-2 were at greater risk of developing T2DM within a year, even those with mild or asymptomatic infection, although risk increased with severity of illness.
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.
Type 2 diabetes, or diabetes mellitus type 2, is a chronic illness notable for high blood sugar and often associated with obesity in adults. It can also occur in children, particularly overweight children. It is sometimes called noninsulin-dependent diabetes.
Who’s At Risk
Adults, adolescents, and children with increased body mass index (BMI) over the 85th percentile are most at risk of contracting type 2 diabetes, especially when 2 other risk factors are present:
History of obesity
Close relative with type 2 diabetes
African or Asian / Pacific ethnic origin
Mother had diabetes during pregnancy
Signs of insulin resistance (high blood pressure, small birth weight, high cholesterol, polycystic ovaries)
Type 2 diabetes is also more likely to occur under these conditions:
Increased age (more commonly over 45)
Lack of physical activity
While taking certain medications
Signs & Symptoms
Type 2 diabetes can occur with no apparent signs and symptoms except sugar in the urine. When symptomatic, common signs can be excessive thirst, frequent urination, unplanned weight loss, or recurrent yeast infections. Other symptoms include tiredness, blurred vision, increased hunger, dark skin patches (acanthosis nigricans), and slow-healing skin sores or infections.
Self-Care Guidelines
Follow directions of your health care provider and management team (doctor, nurse, diabetes educator, or nutritionist) to maintain safe glucose levels and avoid future complications. Improving your diet, exercising, and quitting smoking will promote good health. Monitor your blood sugar level daily and take prescribed oral medications or prescribed self-administered insulin treatments.
When to Seek Medical Care
If you notice symptoms of diabetes, contact your health care provider.
If you have been diagnosed with diabetes and notice signs of infection or other complications developing, contact your doctor immediately. Diabetic complications can lead to blindness, nerve damage in your lower extremities, circulation problems leading to toe or finger amputation, or kidney failure.
If your blood sugar level is too high or too low for more than 2 readings, see your doctor. Symptoms of low blood sugar include sweating, shaking, weakness, hunger, nausea, dizziness, headache, blurred vision, and confusion. Check with your doctor if you have symptoms of low blood sugar.
Severe hypoglycemia is a medical emergency. Call emergency services if you have blurred vision, trouble staying awake, confusion, loss of consciousness, fast breathing, or abdominal pain with vomiting.
Treatments
Type 2 diabetes is a lifelong disorder that requires daily management. Your health care provider will provide you with instructions for self-care. You may also receive medications (insulin or pills) to maintain a normal blood sugar level, and you may require medications to manage your cholesterol and blood pressure.
Most importantly, your health care provider can connect you with long-term diabetic services, health and nutrition classes, support groups, and ongoing monitoring, since failure to maintain lifelong treatment leads to blindness, nerve damage, amputation, cardiovascular and kidney disease, organ failure and early death.
Patient Information for Diabetes mellitus type 2