Clinical presentation of diabetes

Acute and subacute presentations often overlap.

Acute presentation:

Young people may present with a 2-4 wk history and report the classic triad of symptoms:

• Polyuria (due to osmotic diuresis)
• Thirst
• Weight loss (accelerated breakdown of muscle / fat secondary to insulin deficiency)

Ketoacidosis may be the presenting feature if these early symptoms are not recognised and treated.

Subacute presentation:

Clinical onset may be over several months, particularly in older patients.

Common features include:

• Polyuria
• Thirst
• Weight loss

Medical attention is commonly sought for:

• Visual blurring
• Lack of energy
• Pruritis vulvae or balanitis that is due to Candida infection.

Complications as the presenting feature:

• Staphylococcal skin infections
• Retinopathy
• Polyneuropathy causing tingling and numbness in the feet
• Impotence
• Arterial disease (MI or peripheral gangrene)