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DAINIK NATION BUREAU
Once the diagnosis is made, attention should be directed to symptoms related to diabetes (acute and chronic) and classifying the type of diabetes. DM and its complications produce a wide range of symptoms and signs; those secondary to acute hyperglycemia may occur at any stage of the disease， whereas those related to chronic hyperglycemia begin to appear during the second decade of hyperglycemia Diabetes-related complications affect many organ systems and are responsible for the majority of morbidity and mortality associated with the disease. Diabetes-related complications usually do not appear until the second decade of hyperglycemia.
Because type 2 diabetes mellitus often has a long asymptomatic period of hyperglycemia before diagnosis, many individuals with type 2 diabetes mellitus have complications at the time of diagnosis. Diabetes-related complications can be divided into vascular and nonvascular complications and are similar for type 1 and type 2 diabetes mellitus. The vascular complications of diabetes mellitus are further subdivided into microvascular (affect eye, nerve and kidney) and macrovascular complications (affect heart, blood vessels and brain) . Microvascular complications are diabetes-specific whereas macrovascular complications are similar to those in nondiabetics but occur at greater frequency in individuals with diabetes. Non vascular complications include decreased motility of gut，infections, skin changes and hearing loss. Whether type 2 diabetes mellitus increases the risk of dementia or impaired cognitive function is not clear.
Dr S K Varun
senior Consultant physician and diabetologist
department of internal medicine
Synergy Institute of Medical Sciences Dehradun U.K.
