How is diabetes mellitus (DM) type determined?

Updated: Sep 27, 2021
  • Author: Romesh Khardori, MD, PhD, FACP; Chief Editor: George T Griffing, MD  more...
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Correctly determining whether a patient has type 1 or type 2 diabetes is important because patients with type 1 diabetes require continuous exogenous insulin for survival. In contrast, treatment of type 2 diabetes consists of lifestyle measures and a variety of other medications, with insulin introduced if those prove inadequate.

As previously stated, patients with type 2 diabetes mellitus can usually be differentiated from those with type 1 disease on the basis of history and physical examination findings and through simple laboratory tests. Patients with type 2 diabetes are generally obese, and may have acanthosis nigricans and/or hirsutism in conjunction with thick necks and chubby cheeks.

A patient whose diabetes has been controlled with diet or an oral antidiabetic agent for longer than several months generally has type 2 diabetes. A lean patient who has had diabetes since childhood, who has always been dependent on insulin, or who has a history of diabetic ketoacidosis (DKA) almost certainly has type 1 diabetes.

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