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Diabetes may present with characteristic symptoms and signs (Table 2).However, the type of diabetes cannot always be determined at diagnosis, and initial treatment decisions should be based on clinical presentation and plasma glucose values.As a result, in the absence of biochemical testing, hyperglycaemia sufficient to cause pathological and functional changes may be present for a long time before a diagnosis is made, resulting in the presence of complications at diagnosis.(2,3)
Diabetes may present with characteristic symptoms and signs (Table 2). It is estimated that a significant percentage of cases of type 2 diabetes (T2DM) (30% to 80%, depending on the country) are undiagnosed. The most severe clinical manifestations are ketoacidosis or a non-ketotic hyperosmolar state that may lead to dehydration, coma and, in the absence of effective treatment, death. However, symptoms in T2DM are often not severe, or may be absent, owing to the slow pace at which the hyperglycaemia is worsening. As a result, in the absence of biochemical testing, hyperglycaemia sufficient to cause pathological and functional changes may be present for a long time before a diagnosis is made, resulting in the presence of complications at diagnosis. (4)
Type 1 diabetes is more likely to present with symptoms and its onset is typically in children and young adults. However, the type of diabetes cannot always be determined at diagnosis, and initial treatment decisions should be based on clinical presentation and plasma glucose values. (2,3)
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