Type 1: Autoimmune (no insulin production); typically presents as child or early adulthood; can present later on; linked to family history and also exposures/other events
Type 2: Insulin resistance; presents later in life; in particular, related to obesity, family history
Latent Autoimmune Diabetes in Adults (LADA): Autoimmune (like type 1) DM w/decreased insulin production; features include age onset < 50, often symptoms (polyuria, polydipsia, wt loss), BMI < 25, normal lipids, personal or fam hx autoimmune dz.
Risk Factors
Type 1: Family history; Other autoimmune diseases: Thyroid d/o: Hashimotos, Graves; celiac dz, vitiligo, addisons, autoimmune hepatitis
Type 2: elevated BMI; first degree relative w/DM; Age > 45; Ethnicity: African-American, Pacific Islander, Native American, Filipino, Hispanic; HTN, known CVD, low hdl/elevated TGs; Hx PCOS
Symptoms
Fatigue
When poorly controlled (or undiagnosed) associated with polyuria, polydypsia,
Can cause severe illness from hypovolemia
Weight loss w/type 1, weight gain w/type 2
Type 2 often asymptomatic for years
Presenting sx can relate to target organ dysfxn (e.g. MI, PAD/foot ulcer, neuropathy, kidney disease, retinopathy)