There are two different types of diabetes mellitus. In type 1 diabetes mellitus, the problem is that the pancreas (an organ in the abdomen) does not make enough insulin. In type 2 diabetes mellitus, the pancreas does not make enough insulin, the body becomes resistant to normal or even high levels of insulin, or both. This causes high blood glucose (blood sugar) levels, which can cause problems if untreated.



The majority of patients with type 2 diabetes are asymptomatic, and hyperglycemia is noted on routine laboratory evaluation, prompting further testing. Classic symptoms of hyperglycemia include polyuria, polydipsia, nocturia, blurred vision, and, infrequently, weight loss. These symptoms are often noted only in retrospect after an elevated blood glucose value has been documented. And hence, it is very important to get screened at least annually.



Treatment of patients with type 2 diabetes mellitus includes education, evaluation for microvascular and macrovascular complications, attempts to achieve near-normal glycemia, minimization of cardiovascular and other long-term risk factors, and avoidance of drugs that can aggravate abnormalities of insulin or lipid metabolism. All of these treatments need to be tempered based on individual factors, such as age, life expectancy, and comorbidities. Although several studies have noted remissions of type 2 diabetes mellitus that may last several years, most patients require continuous treatment in order to maintain normal or near-normal glycemia.