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Endocrinology: diabetes mellitus — type 1, type 2, complications

General Medicine · MBBS

Study notes

Excessive thirst, urination, weight loss in a 25-year-old — type 1 diabetes; insulin for life. Type 1 (autoimmune beta-cell destruction — young, lean: polydipsia, polyuria, weight loss; DKA risk): insulin from diagnosis — basal-bolus. Type 2 (insulin resistance — adult, overweight: often asymptomatic; screen): lifestyle + metformin first, then add (SGLT2i/GLP-1 — cardio-renal benefit) → insulin if uncontrolled. Diagnosis — FPG ≥126, 2-hr ≥200, HbA1c ≥6.5%. Complications — microvascular (retinopathy — annual eye; nephropathy — albuminuria; neuropathy — foot care) + macrovascular (MI, stroke). DKA (hyperglycemia + ketones + acidosis — fluids, insulin infusion, potassium). The thirst-triad is diabetes — test the sugar.

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