Type 2 Diabetes Mellitus: Ease of Diagnosis, and Choice of Treatment

Bibliography link: Shestakova M. V., Sukhareva O. Yu. Type 2 Diabetes Mellitus: Ease of Diagnosis, and Choice of Treatment. Doctor.Ru. 2017; 13(142)—14(143): 44–51.
Type 2 Diabetes Mellitus: Ease of Diagnosis, and Choice of Treatment
19 December 00:00

Objective of the Review: To raise awareness among medical specialists (internists, general/family practitioners, etc.) about the early diagnosis, differential diagnosis, and treatment of type 2 diabetes mellitus (T2DM) as the most significant endocrine disorder recognized as a noninfectious epidemic in the 21st century.

Key Points: Although diagnosis of T2DM may seem easy, it is often delayed. Thus, treatment is not timely administered, which results in a high rate of microvascular and macrovascular complications. The review describes the main clinical and laboratory diagnostic markers of T2DM, and the characteristic features of other etiopathogenic types of DM in adults and children that mimic T2DM. It also compares the effectiveness, advantages, and shortcomings of modern glucose-lowering agents.

Conclusion: Timely diagnosis of T2DM is difficult because its clinical signs are vague and may be absent. In this situation, screening of those at risk for T2DM requires the active involvement of general practitioners and doctors specializing in other fields.

If other types of diabetes (immune or monogenic) are suspected, patients should be referred to specialized centers for diagnosis and personalized treatment.

M. V. Shestakova — National Medical Research Center for Endocrinology, Moscow. E-mail:

O. Yu. Sukhareva — National Medical Research Center for Endocrinology, Moscow. E-mail:

Type 2 Diabetes Mellitus: Ease of Diagnosis, and Choice of Treatment
19 December 00:00
  1. International Diabetes Federation. IDF Diabetes Atlas, 7th Edition, 2015. (дата обращения — 11.10.2017).
  2. Дедов И. И., Шестакова М. В., Викулова О. К. Эпидемиология сахарного диабета в Российской Федерации: клинико-статистический анализ по данным Федерального регистра сахарного диабета. Сахарный диабет. 2017; 20(1): 13–41. [Dedov I. I., Shestakova M. V., Vikulova O. K. Epidemiologiya sakharnogo diabeta v Rossiiskoi Federatsii: kliniko-statisticheskii analiz po dannym Federal'nogo registra sakharnogo diabeta. Sakharnyi diabet. 2017; 20(1): 13–41. (in Russian)]
  3. Дедов И. И., Шестакова М. В., Галстян Г. Р. Распространенность сахарного диабета 2 типа у взрослого населения России (исследование NATION). Сахарный диабет. 2016; 19(2): 104–12. [Dedov I. I., Shestakova M. V., Galstyan G. R. Rasprostranennost' sakharnogo diabeta 2 tipa u vzroslogo naseleniya Rossii (issledovanie NATION). Sakharnyi diabet. 2016; 19(2): 104–12. (in Russian)]
  4. Use of glycated haemoglobin (HbA1c) in the diagnosis of diabetes mellitus. Abbreviated report of a WHO consultation (WHO/NMH/ CHP/CPM/11.1). World Health Organization, 2011. http://www. (дата обращения — 11.10.2017).
  5. Дедов И. И., Шестакова М. В., Майоров А. Ю., ред. Алгоритмы специализированной медицинской помощи больным сахарным диабетом (8-й выпуск). Сахарный диабет. 2017; 20(1S): 1–112. [Dedov I. I., Shestakova M. V., Maiorov A. Yu., red. Algoritmy spetsializirovannoi meditsinskoi pomoshchi bol'nym sakharnym diabetom (8-i vypusk). Sakharnyi diabet. 2017; 20(1S): 1–112. (in Russian)]
  6. Дедов И. И., Шестакова М. В. Персонализированная терапия сахарного диабета: путь от болезни к больному. Терапевт. архив. 2014; 10: 4–9. [Dedov I. I., Shestakova M. V. Personalizirovannaya terapiya sakharnogo diabeta: put' ot bolezni k bol'nomu. Terapevt. аrkhiv. 2014; 10: 4–9. (in Russian)]
  7. Chaillous L., Bouhanick B., Kerlan V., Mathieu E., Lecomte P., Ducluzeau P. H. et al. Clinical and metabolic characteristics of patients with latent autoimmune diabetes in adults (LADA): absence of rapid beta-cell loss in patients with tight metabolic control. Diabetes Metab. 2010; 36(1): 64–70.
  8. Смирнова О. М., Кононенко И. В., Дедов И. И. Гетерогенность сахарного диабета. Аутоиммунный латентный сахарный диабет у взрослых (LADA): определение, распространенность, клинические особенности, диагностика, принципы лечения. Сахарный диабет. 2008; 4: 18–23. [Smirnova O. M., Kononenko I. V., Dedov I. I. Geterogennost' sakharnogo diabeta. Autoimmunnyi latentnyi sakharnyi diabet u vzroslykh (LADA): opredelenie, rasprostranennost', klinicheskie osobennosti, diagnostika, printsipy lecheniya. Sakharnyi diabet. 2008; 4: 18–23. (in Russian)]
  9. Соркина Е. Л. Липоатрофический диабет. В кн.: Дедов И. И., Шестакова М. В., ред. Сахарный диабет: многообразие клинических форм М.: ООО «Медицинское информационное агентство»; 2016. 224 с. [Sorkina E. L. Lipoatroficheskii diabet. V kn.: Dedov I. I., Shestakova M. V., red. Sakharnyi diabet: mnogoobrazie klinicheskikh form M.: OOO “Meditsinskoe informatsionnoe agentstvo”; 2016. 224 s. (in Russian)]
  10. Кураева Т. Л., Зильберман Л. И., Титович Е. В., Петеркова В. А. Генетика моногенных форм сахарного диабета. Сахарный диабет. 2011; 1: 20–7. [Kuraeva T. L., Zil'berman L. I., Titovich E. V., Peterkova V. A. Genetika monogennykh form sakharnogo diabeta. Sakharnyi diabet. 2011; 1: 20–7. (in Russian)]
  11. De Fronzo R. A. From triumvirate to the ominous octet: а new paradigme for the treatment of type 2 diabetes mellitus. Diabetes. 2009; 58(4): 773–95.
  12. Дедов И. И., Шестакова М. В., Аметов А. С., Анциферов М. Б., Галстян Г. Р., Майоров А. Ю. и др. Инициация и интенсификация сахароснижающей терапии у больных сахарным диабетом 2 типа: обновление консенсуса совета экспертов Российской ассоциации эндокринологов (2015 г.). Сахарный диабет. 2015; 18(1): 5–23. [Dedov I. I., Shestakova M. V., Ametov A. S., Antsiferov M. B., Galstyan G. R., Maiorov A. Yu. i dr. Initsiatsiya i intensifikatsiya sakharosnizhayushchei terapii u bol'nykh sakharnym diabetom 2 tipa: obnovlenie konsensusa soveta ekspertov Rossiiskoi assotsiatsii endokrinologov (2015 g.). Sakharnyi diabet. 2015; 18(1): 5–23. (in Russian)]
  13. Marso S. P., Daniels G. H., Brown-Frandsen K., Kristensen P., Mann J. F., Nauck M. A. et al. Liraglutide and cardiovascular outcomes in type 2 diabetes. N. Eng. J. Med. 2016; 375(4): 311–22.
  14. Marso S. P., Bain S. C., Consoli A., Eliaschewitz F. G., Jódar E., Leiter L. A. et al. Semaglutide and cardiovascular outcomes in patients with type 2 diabetes. N. Engl. J. Med. 2016; 375(19): 1834–44.
  15. Zinman B., Wanner C., Lachin J. M., Fitchett D., Bluhmki E., Hantel S. et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N. Eng. J. Med. 2015; 373(22): 2117–28.
  16. Neal B., Perkovic V., Mahaffey K. W., de Zeeuw D., Fulcher G., Ngozi F. et al. Canagliflozin and cardiovascular and renal events in type 2 diabetes. N. Engl. J. Med. 2017; 377(7): 644–57.
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