Pathophysiology

• Insulin action is diminished in T2DM through insulin resistance: the inability of insulin to produce its usual biological effects at physiological concentrations
  • Insulin resistance results from nutrient excess
• The hyperglycaemic and lipidaemic profile of the blood results in gluco-lipotoxicity (toxic to B-cells) and pancreatic beta cells lose the ability to release insulin, at this point T2DM is diagnosed.
• A continued onslaught of glucose on the body in light of insulin resistance and pancreatic fatigue leads to chronic hyperglycaemia. Chronic hyperglycaemia leads to microvascular, macrovascular and infectious complications

Risk Factors

Modifiable:

• Obesity
• Sedentary lifestyles
• High carbohydrate (particularly refined carbohydrate) diet

Non-modifiable:

• Older age
• Ethnicity (Black, Chinese, South Asian)
• Family history

PC

Screening for HbA1C and early treatment is crucial to preventing long term complications - can reverse diabetes with proper diet and lifestyle. Patients can present with:

• Fatigue