How does diabetes develop? The onset of diabetes is slow in most people with diabetes. In particular, patients with type 2 diabetes may gradually develop thirst, excessive drinking, polyphagia, polyuria, weight loss, and weight loss over a period of months or nearly one to two years. Because the patient’s self-perception of thirst and excessive drinking is not initially obvious, the time of onset is often not clearly remembered, making it impossible to accurately calculate the duration of the disease. Some people also develop complications, such as blurred vision, vision loss, limb pain, proteinuria, swelling, periodontitis, coronary artery disease, hypertension, and cerebral thrombosis. The diagnosis of diabetes was confirmed only after high blood glucose and urine sugar tests at the time of medical consultation. There are also patients who have neither symptoms nor complications of diabetes, but are only found to have diabetes during a health checkup or examination for other diseases. In general, those who seek treatment for diabetic neuropathy such as lower extremity pain and impotence are likely to have diabetes detected earlier. This is because the neurological symptoms of diabetes can precede the typical symptoms of diabetes mellitus, which are “three more and one less”. However, patients who seek treatment for diabetic retinopathy or nephropathy such as blurred vision, swelling, proteinuria, or renal failure have had the disease for a longer period of time, at least 2 to 5 years. Most patients with unstable diabetes mellitus, and a few adult patients with diabetes mellitus, especially the elderly, often present with acute onset in the presence of triggers such as infection. Patients may have more pronounced thirst and excessive drinking, nausea and vomiting, loss of appetite, headache and drowsiness, irritability, decreased blood pressure, deep and rapid breathing, a rotten apple taste in the mouth, possible confusion, and ketoacidosis or hyperosmolar coma at the first onset.