Diabetes Mellitus Type 2

Type 2 Diabetes Mellitus

Type 2 diabetes is a chronic metabolic disorder characterized by insulin resistance and relative insulin deficiency, leading to elevated blood glucose levels.

Diagnostic Criteria

• Fasting plasma glucose ≥ 126 mg/dL
• HbA1c ≥ 6.5%
• 2-hour plasma glucose ≥ 200 mg/dL during OGTT
• Random glucose ≥ 200 mg/dL with symptoms

Treatment Algorithm

First Line

1. Lifestyle modifications — diet, exercise, weight management
2. Metformin — remains gold standard initial therapy

Second Line (add-on)

• SGLT2 inhibitors — cardiovascular and renal benefits
• GLP-1 receptor agonists — weight loss benefits
• DPP-4 inhibitors — weight neutral option

Advanced

• Basal insulin when oral agents insufficient
• Combination insulin regimens for complex cases

Monitoring Goals

• HbA1c < 7% (individualized)
• Blood pressure < 130/80 mmHg
• LDL cholesterol < 100 mg/dL
• Annual eye, foot, and kidney screening

Prevention: 150 minutes/week of moderate exercise and 5-7% weight loss can reduce diabetes risk by 58% in pre-diabetic patients.