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Overview of medical care in adults with diabetes mellitus

David K McCulloch, MD
Section Editor
David M Nathan, MD
Deputy Editor
Jean E Mulder, MD


The estimated overall prevalence of diabetes among adults in the United States ranges from 5.8 to 12.9 percent (median 8.4 percent) [1,2]. More personal health care resources are estimated to be spent on diabetes than any other condition [3]. Numerous factors, in addition to directly related medical complications, contribute to the impact of diabetes on quality of life and economics. Diabetes is associated with a high prevalence of depression [4] and adversely impacts employment, absenteeism, and work productivity [5].

This review will provide an overview of the medical care for patients with diabetes (table 1). The management approach is consistent with guidelines from the American Diabetes Association (ADA) for health maintenance in patients with diabetes, which are published yearly [6]. Consensus recommendations for the management of glycemia in type 2 diabetes were published in 2006 and are updated regularly. Detailed discussions relating to screening, diagnosis, and management of hyperglycemia are discussed separately. (See "Screening for type 2 diabetes mellitus" and "Clinical presentation and diagnosis of diabetes mellitus in adults" and "Initial management of blood glucose in adults with type 2 diabetes mellitus" and "Management of persistent hyperglycemia in type 2 diabetes mellitus".)


Initial — Patients with newly diagnosed diabetes require a history and physical examination to assess the characteristics of onset of diabetes (asymptomatic laboratory finding or symptomatic polyuria and polydipsia), nutrition and weight history, physical activity, cardiovascular risk factors, history of diabetes-related complications, hypoglycemic episodes, diabetic ketoacidosis (DKA) frequency (type 1 diabetes only), and current management. Although the more diabetes-specific microvascular complications are duration dependent, such complications may be present in newly diagnosed patients owing largely to typical delays in diagnosing type 2 diabetes.

If not measured in the past two to three months, we measure glycated hemoglobin (A1C) (see "Estimation of blood glucose control in diabetes mellitus", section on 'Glycated hemoglobin')

If not measured in the past one year, we measure:

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Literature review current through: Dec 2017. | This topic last updated: Dec 11, 2017.
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