1.6 Clinical presentation

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1.6 Clinical presentation^{1, 2, 4, 6}

The spectrum of presentation ranges from asymptomatic to typical features.

• Asymptomatic cases are diagnosed by biochemical tests only. A vast majority of T2DM and other types remain asymptomatic over a prolonged period. Routine check-up usually picks up this form of DM. T1DM is always symptomatic and shows classical features of hyperglycemia.
  
  
• Typical features of DM start with glycosuria, which begins after the blood glucose level has gone above an individual's renal threshold for glucose. Features include polyuria, polydipsia, polyphagia, weight loss and generalized weakness. These are mostly seen in the presentation of T1DM, though not so common in other types.
  
  
• Atypical manifestations are non-specific, which include non-healing infection, infertility or repeated pregnancy loss, pruritus vulvae, undue fatigability etc. This is a common mode of presentation in T2DM.
  
  
• Specific complications of DM may be present at the time of diagnosis. In T2DM and other forms of diabetes mellitus, presentations may remain asymptomatic for quite a long period resulting in late diagnosis and intervention. So significant proportion of T2DM cases presents with one or more chronic complications. All T1DM cases are usually diagnosed before the development of chronic complications.