Typically > 40 years of age
Candidal vaginitis sometimes an initial manifestation
Often few or no symptoms
After an overnight fast, plasma glucose ≥ 126 mg/dL (7 mmol/L) more than once
After 75 g oral glucose, diagnostic values are ≥ 200 mg/dL (11.1 mmol/L) 2 h after the oral glucose
Often associated with hypertension, dyslipidemia, and atherosclerosis
Circulating endogenous insulin is sufficient to prevent ketoacidosis but inadequate to prevent hyperglycemia from tissue insensitivity
Strong genetic influences
Prevalence of obesity in type 2 diabetes mellitus
30% in Chinese and Japanese
60–70% in North Americans, Europeans, and Africans
Nearly 100% in Pima Indians and Pacific Islanders from Nauru or Samoa
Abdominal fat, with an abnormally high waist–hip ratio, is generally associated with obesity in type 2 diabetes. This visceral obesity correlates with insulin resistance, whereas subcutaneous fat seems to have less of an association
∼28 million Americans have type 2 diabetes
Traditionally occurred in middle-aged adults but now more frequently encountered in children and adolescents
Vulvovaginitis or anogenital pruritus or balanoposthitis
Subtotal pancreatectomy
Hemochromatosis ("bronze diabetes")
Schmidt syndrome (polyglandular failure: Addison disease, autoimmune thyroiditis, diabetes)
Nondiabetic glycosuria (benign)
Fasting plasma glucose ≥ 126 mg/dL (7 mmol/L) or ≥ 200 mg/dL (11.1 mmol/L) 2 h after glucose load (Table 27–4)
HbA1c of at least 6.5%
Ketonuria on occasion without ketonemia (Acetest, Ketostix)
HbA1c reflects glycemic control over preceding 8–12 weeks
Helpful in the presence of abnormal hemoglobins and in ascertaining glycemic control at time of conception among diabetic women
Lipoprotein abnormalities in obese persons with type 2 diabetes include
High serum triglyceride (300–400 mg/dL)
Low high-density lipoprotein (HDL) cholesterol (< 30 mg/dL)
A qualitative change in low-density lipoprotein (LDL) particles
These abnormalities differ from type 1 diabetes, which is associated with only ...