In type 2 diabetes, the classic symptomatology of insulin deficiency seen in type 1 diabetics rarely exists. A type 2 diabetic with mildly or only passively elevated blood glucose levels may remain completely asymptomatic, that is, without symptoms. Such a situation may prevail in type 2 diabetes for a prolonged period, sometimes for several years, and then significantly delay diagnosis.
The diagnosis is often made by chance during a routine blood glucose test. This makes it understandable why up to 20% of type 2 diabetics already have diabetic organ complications at the time of diagnosis.
Only occasionally do patients complain of complaints such as pruritus (itching), balanitis (inflammation of the glans), declining libido or even paresthesias (insensations) and pain in the legs. They often have a red face that is called rubeosis diabetica. These patients – mostly older than 40 years – have obesity with android, i.e. truncal, body fat distribution, hypertension (high blood pressure), hypertriglyceridemia (fat metabolism disorder with elevation of triglycerides) with hepatomegaly (liver enlargement) due to fat storage in the liver.
The following symptoms and complaints may indicate type 2 diabetes mellitus:
- Polyuria – increased urination.
- Severe thirst, due to water loss.
- Feeling of weakness
- Fatigue
- Anorexia (loss of appetite)
- Weight loss
- Cravings
- Fatigue and poor performance
- Visual disturbances
- Acetone odor – smell of nail polish remover.
Attention. About half of patients are asymptomatic, ie does not show symptoms. At diagnosis, diabetes mellitus usually already exists for about 5-10 years. Often, typical secondary diseases such as nephropathy (kidney disease), neuropathy (nerve damage) and retinopathy (disease of the retina) lead to the diagnosis.
Diabetes mellitus type 2 is one of the classic diseases of aging.
Warning signs (red flags)
- If new-onset diabetes mellitus is associated with weight loss, the risk for pancreatic cancer is increased: Weight loss of one to eight pounds is associated with about three and a half times the risk of pancreatic cancer (HR 3.47; 0.66%).
- Patient > 80 years of age + unintentional weight loss → think of: Dementia
