Presentations

Patients may seek help with the classical symptoms of hyperglycaemia, symptoms of diabetic tissue damage, or those of conditions causing diabetes. Some patients may present with symptoms not usually associated with diabetes but glycosuria or hyper-glycaemia may be found as part of routine screening. Other people, who believe themselves to be well, undergo physical and biochemical examination for employment, insurance purposes, or health screening (Table 1.1).

The way in which the diagnosis comes to light influences the patient's attitude to his or her condition. Those with thirst and polyuria want relief from their symptoms and may be more likely to comply with treatment than those patients who feel well.

Table 1.1 The path to diagnosis of diabetes Patient-initiated

Symptoms of hyperglycaemia (e.g. thirst, polyuria) Symptoms of diabetic tissue damage

Symptoms of conditions causing diabetes (e.g. steroid excess) Unrelated symptoms leading to general biochemical screen

Screening

Well-person health check (state decreed or patient request) Insurance medical Employment medical

During training in glucose testing (e.g. nurse)

Fig. 1.1 Symptoms of diabetes
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