2diabetes

Type 2 diabetes mellitus (T2DM) is a chronic metabolic disorder characterized by insulin resistance and progressive beta‑cell dysfunction, leading to elevated blood glucose and impaired glucose regulation.

It is the most common form of diabetes worldwide. Major risk factors include overweight or obesity, physical inactivity, age, family history, certain ethnic backgrounds, and other metabolic conditions such as hypertension and dyslipidemia.

Pathophysiology involves reduced tissue sensitivity to insulin and inadequate beta‑cell compensation. The liver may overproduce glucose, and impaired incretin responses worsen hyperglycemia. Long-term hyperglycemia increases the risk of vascular complications.

Symptoms may be mild or absent initially. When present, thirst, frequent urination, fatigue, blurred vision, or infections can occur. Diagnosis relies on: HbA1c ≥6.5%, fasting plasma glucose ≥126 mg/dL, 2‑hour plasma glucose ≥200 mg/dL during an oral glucose tolerance test, or a random glucose ≥200 mg/dL with symptoms.

Management emphasizes lifestyle changes—weight reduction, regular physical activity, and a balanced diet. Pharmacotherapy usually starts with metformin; additional agents such as SGLT2 inhibitors, GLP‑1 receptor agonists, DPP‑4 inhibitors, sulfonylureas, or insulin may be added based on needs and comorbidities. Targets commonly include HbA1c <7%.

Monitoring includes periodic HbA1c testing (every 3 months until controlled, then every 3–6 months) and screening for microvascular complications (eye, kidney, nerve) and cardiovascular risk factors. Blood pressure and lipid management are integral.

Prevention focuses on risk reduction through healthy lifestyle and early treatment. With good control, many people live active lives; prognosis depends on comorbidities and complication prevention.