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Diabetes tipo 2 en adultos

Última revisión: 21 Oct 2024
Última actualización: 16 Feb 2024

Resumen

Definición

Anamnesis y examen

Principales factores de diagnóstico

  • presencia de factores de riesgo
  • asintomático
  • polidipsia
  • poliuria
Todos los datos

Otros factores de diagnóstico

  • infecciones por Cándida
  • infecciones de la piel
  • infecciones del tracto urinario
  • fatiga
  • visión borrosa
  • polifagia
  • pérdida de peso involuntaria
  • parestesias
  • acantosis pigmentaria
Todos los datos

Factores de riesgo

  • edad avanzada
  • sobrepeso/obesidad
  • diabetes gestacional
  • hiperglucemia no diabética
  • antecedentes familiares de diabetes tipo 2
  • ascendencia no blanca
  • síndrome del ovario poliquístico
  • hipertensión
  • dislipidemia
  • enfermedad cardiovascular
  • estrés
Todos los datos

Pruebas diagnósticas

Primeras pruebas diagnósticas para solicitar

  • glucosa plasmática en ayunas
  • HbA1c
  • glucosa poscarga de 2 horas después de 75 g de glucosa oral
  • glucosa plasmática al azar
Todos los datos

Pruebas diagnósticas que deben considerarse

  • lipidograma en ayunas
  • cetonas en orina
  • relación albúmina/creatinina (ACR)
  • creatinina sérica y TFG estimada
  • electrocardiograma (ECG)
  • índice de presión tobillo-brazo (ABPI)
  • péptido C aleatorio
  • pruebas de autoanticuerpos
  • pruebas de función hepática
Todos los datos

Algoritmo de tratamiento

Inicial

en el diagnóstico inicial

Agudo

HbA1C por encima del objetivo: no embarazada

HbA1C por encima del umbral acordado en la farmacoterapia inicial o cambios en el riesgo cardiovascular: no embarazadas

embarazadas

Colaboradores

Autores

Surya Rajeev, MBBS, MRCP, MD

Consultant Physician and Clinical Director

Department of Diabetes and Endocrinology

Liverpool University Hospital NHS Foundation Trust

UK

Divulgaciones

SR has received reimbursement from Novo Nordisk for conferences, and has presented paid lectures.

Agradecimientos

Dr Surya Rajeev would like to gratefully acknowledge Dr Partha Kar, Dr Amar Puttanna, Dr Patrick J. O'Connor and Dr JoAnn M. Sperl-Hillen, the previous contributors to this topic.

Divulgaciones

PK has sat on advisory boards and attended events reimbursed by Novo Nordisk, Eli Lilly, and Sanofi. AP has received honoraria from Napp, Novo Nordisk, Sanofi, Lilly-Boehringer Ingelheim, Daiichi-Sankyo, and AstraZeneca for presentation at meetings, conference registration, or participating in advisory boards. PJO receives research funding from the National Institutes of Health on multiple projects and is an author of a number of references cited in this topic. JMS-H is an author of a number of references cited in this topic and is an inventor on a US patent for Disease Treatment Simulation, a simulation-based technology developed without commercial support to educate health providers on chronic disease management in a virtual environment.

Revisores por pares

Vinod Patel, MD, FRCP, FHEA, MRCGP, DRCOG, MBChB, BSc (Hons), RCPathME

Professor, Diabetes and Clinical Skills

Warwick Medical School

University of Warwick

Hon Consultant in Endocrinology and Diabetes, Acute Medicine, Medical Obstetrics

Diabetes and Endocrinology Centre

George Eliot Hospital NHS Trust

Nuneaton

Clinical Director for Diabetes West Midlands Clinical Networks & Clinical Senate

NHS England and NHS Improvement - Midlands

UK

Divulgaciones

VP declares he has worked with most of the large pharmaceutical industry groups over the years with the majority of the work being in education of healthcare professionals in diabetes care. This includes Novo Nordisk, Eli Lily, MSD, BI, Sanofi, Napp, Internis, Takeda, and AZ. VP has been part of advisory board work on occasions. VP has received conference arrangements and lecture fees. VP is a trustee of the charity South Asian Health Foundation.

Gregory Lip, MD, FRCP, DFM, FACC, FESC, FEHRA

Price-Evans Professor of Cardiovascular Medicine

University of Liverpool

Senior Investigator

National Institute for Health Research

UK

Distinguished Professor

Faculty of Medicine

Aalborg University

Denmark

Adjunct Professor

Yonsei University

Seoul

South Korea

Divulgaciones

GL has acted as a consultant and speaker for BMS/Pfizer, Boehringer Ingelheim, and Daiichi-Sankyo.

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