Resumo
Definição
História e exame físico
Principais fatores diagnósticos
- presencia de factores de riesgo
- asintomático
- polidipsia
- poliuria
Outros fatores diagnósticos
- infecciones por Cándida
- infecciones de la piel
- infecciones del tracto urinario
- fatiga
- visión borrosa
- polifagia
- pérdida de peso involuntaria
- parestesias
- acantosis pigmentaria
Fatores de risco
- 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
Investigações diagnósticas
Primeiras investigações a serem solicitadas
- glucosa plasmática en ayunas
- HbA1c
- glucosa poscarga de 2 horas después de 75 g de glucosa oral
- glucosa plasmática al azar
Investigações a serem consideradas
- 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 (PFH)
Algoritmo de tratamento
en el diagnóstico inicial
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
Declarações
SR has received reimbursement from Novo Nordisk for conferences, and has presented paid lectures.
Agradecimentos
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.
Declarações
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
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
Declarações
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
Declarações
GL has acted as a consultant and speaker for BMS/Pfizer, Boehringer Ingelheim, and Daiichi-Sankyo.
Peer reviewer acknowledgements
BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.
Disclosures
Peer reviewer affiliations and disclosures pertain to the time of the review.
Referências
Principais artigos
National Institute for Health and Care Excellence. Type 2 diabetes in adults: management. Jun 2022 [internet publication].Texto completo
Marx N, Federici M, Schütt K, et al. 2023 ESC Guidelines for the management of cardiovascular disease in patients with diabetes. Eur Heart J. 2023 Oct 14;44(39):4043-140.Texto completo Resumo
National Institute for Health and Care Excellence. Diabetes in pregnancy: management from preconception to the postnatal period. Dec 2020 [internet publication].Texto completo
Davies MJ, Aroda VR, Collins BS, et al. Management of hyperglycemia in type 2 diabetes, 2022. A consensus report by the American Diabetes Association (ADA) and the European Association for the Study of Diabetes (EASD). Diabetes Care. 2022 Nov 1;45(11):2753-86.Texto completo Resumo
Artigos de referência
Uma lista completa das fontes referenciadas neste tópico está disponível para os usuários com acesso total ao BMJ Best Practice.
Diagnósticos diferenciais
- Hiperglucemia no diabética (prediabetes)
- Diabetes mellitus, tipo 1
- Diabetes autoinmunitaria latente en adultos (LADA)
Mais Diagnósticos diferenciaisDiretrizes
- 2023 ESC guidelines for the management of cardiovascular disease in patients with diabetes
- Management of hyperglycaemia in type 2 diabetes, 2022
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