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Overview
Type 2 Diabetes
Type 2 Diabetes
Chronic hyperglycaemia due to insulin resistance with progressive β-cell dysfunction. ?
Reasoning goal: confirm diabetes, classify correctly, and identify cardiovascular/renal risk and complications. ?
Therapeutic goal: improve glycaemia and reduce long-term microvascular and cardiovascular harm through lifestyle and risk-based medicines. ?
...
RISK FACTORS
RISK FACTORS
JITL
JITL
EPIDEMIOLOGY
EPIDEMIOLOGY
JITL
JITL
Family history / previous gestational diabetes
Family history / prev...
Central adiposity / inactivity
Central adiposity...
Higher-risk groups (age, ethnicity, deprivation)
Higher-risk groups (a...
Metabolic comorbidities (HTN, dyslipidaemia, MASLD, PCOS)
Metabolic comorbiditi...
Diabetogenic medicines (e.g. steroids, some antipsychotics)
Diabetogenic medicine...
PATHOPHYSIOLOGY
PATHOPHYSIOLOGY
JITL
JITL
β-cell dysfunction (progressive insulin failure)
β-cell dysfunction (progre...
Insulin resistance (liver + muscle)
Insulin resistance (liver...
Adipose dysfunction → ectopic fat (lipotoxicity + inflammation)
Adipose dysfunction → ecto...
Counter-regulatory dysregulation (glucagon + incretin effect)
Counter-regulatory dysreg...
Long silent phase (prediabetes)
Long silent phase (predia...
Progressive β-cell failure (step-up over time)
Progressive β-cell failure...
Complications accrue over time (micro + macro)
Complications accrue over...
NATURAL HISTORY
NATURAL HISTORY
 JITL
UNWELL PATIENTS
UNWELL PATIENTS
JITL
JITL
Clinical Assessment and Management
Clinical Assessment and Management
JITL
JITL
History
History
JITL
JITL
Examination
Examination
JITL
JITL
CLINICAL FEATURES
CLINICAL FEATURES
JITL
JITL
Asymptomatic / incidental detection
Asymptomatic / incidental...
RED FLAGS
RED FLAGS
 JITL
Osmotic symptoms (polyuria, thirst, weight loss)
Osmotic symptoms (polyuri...
Fatigue / blurred vision
Fatigue / blurred vision
Recurrent infections / poor healing
Recurrent infections / po...
Insulin resistance phenotype
Insulin resistance pheno...
DKA pattern (acute decompensation)
DKA pattern (acute decomp...
HHS pattern (severe dehydration)
HHS pattern (severe dehyd...
Sepsis/acute illness + marked hyperglycaemia
Sepsis/acute illness + ma...
Macrovascular disease manifestations
Macrovascular disease man...
Foot ulcer risk pattern
Foot ulcer risk pattern
COMPLICATIONS
COMPLICATIONS
JITL
JITL
Neuropathy (sensory loss / pain)
Neuropathy (sensory loss...
Nephropathy (albuminuria / CKD clues)
Nephropathy (albuminuria...
Retinopathy (visual symptoms)
Retinopathy (visual symp...
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Learn the controls...Novice Guidance Panel Clinical Reasoning Panel
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