Diabetes Mellitus: Types, Complications & Sick-Day Management

Type 1 diabetes involves absolute insulin deficiency (autoimmune destruction of pancreatic beta cells) and always requires exogenous insulin; Type 2 involves insulin resistance and relative deficiency, often manageable initially with lifestyle changes and oral agents before insulin becomes necessary. Long-term complications follow a predictable pattern worth memorizing by system: microvascular (retinopathy, nephropathy, peripheral neuropathy — often presenting as decreased sensation in a stocking-glove distribution, raising foot injury risk) and macrovascular (accelerated cardiovascular disease, stroke, peripheral artery disease). Foot care teaching — daily inspection, properly fitted shoes, never walking barefoot, prompt attention to any wound — exists specifically because neuropathy can mask an injury until it's already infected.