La diabetes mellitus es un conjunto heterogéneo de síndromes que cursan con hiperglucemia como resultado de un defecto en la secreción y/o acción de la insulina. Su diagnóstico se basa en la presencia de una de las tres anomalías siguientes: alteración de la glucosa plasmática en ayunas, elevación ocasional de la glucemia siempre que se acompañe de síntomas cardinales y alteraciones a las dos horas en el test de sobrecarga oral de glucosa. En la patogenia de ambos tipos de diabetes intervienen factores genéticos y ambientales, pero mientras que en la tipo 1 la causante de la enfermedad es una reacción autoinmune contra el páncreas, en la tipo 2 es la resistencia a la insulina, su secreción alterada en respuesta al estímulo de la glucosa y la producción aumentada de glucosa endógena lo que da lugar a la enfermedad. Sus formas de presentación son variables haciéndolo por lo general la tipo 1 de forma más brusca que la tipo 2, que puede permanecer silente durante años. Como prevención primaria de la tipo 2 es fundamental el seguimiento de pacientes con prediabetes o con síndrome metabólico.
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