Precision Diagnostics for Type 2 Diabetes Mellitus - Have We Arrived?

Colling, Caitlin; Rosen, Clifford J · NEJM Evid · 2022

review · Level V

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Abstract

Type 2 diabetes mellitus (T2DM) is defined by a common end point: hyperglycemia diagnosed by fasting plasma glucose, plasma glucose during an oral glucose tolerance test, or hemoglobin A1c without autoimmune β-cell destruction.<sup>1</sup> Historically, little attention has been paid to the etiologies driving hyperglycemia; as a result, there has been an absence of an elegant pathophysiologically directed diagnostic and therapeutic approach. T2DM has simply been thought to be a result of insulin deficiency and/or peripheral insulin resistance. However, the phenotype of T2DM is heterogeneous, as is the pathophysiology.<sup>2,3</sup>.