Differentiating Diabetes mellitus type 2 from other diseases
Diabetes mellitus type 2 Microchapters |
Differentiating Diabetes Mellitus Type 2 from other Diseases |
Diagnosis |
Treatment |
Medical therapy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Type 2 diabetes mellitus must be differentiated from other disorders that may present with polyuria, polydipsia, weight loss or weight gain. Such disorders may include other forms of diabetes mellitus (e.g. type 1 DM, MODY) or other endocrine disorders (e.g. hypothyroidism, cushings syndrome, wolfram syndrome, alstrom syndrome) or drug
Differentiating Diabetes Mellitus Type 2 from other Diseases
Type 2 DM must be differentiated from other forms of diabetes mellitus as well as other endocrine disorders such as: [1][2][3]
- Type 1 DM
- MODY-DM
- Psychogenic polydipsia
- Diabetes insipidus
- Transient hyperglycemia
- Steroid therapy
- Renal tubular acidosis type-1
- Glucagonoma
- Cushing's syndrome
- Hypothyroidism
- Wolfram syndrome
- Alstrom syndrome
The following table shows the appropriate history and symptoms and laboratory findings that may distinguish type 2 DM from other diseases:
Disease | History and symptoms | Laboratory findings | Additional findings | |||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Polyuria | Polydipsia | Polyphagia | Weight loss | Weight gain | Serum glucose | Urinary Glucose | Urine PH | Serum Sodium | Urinary Glucose | 24 hrs cortisol level | C-peptide level | Serum glucagon | ||
Type 1 Diabetes mellitus | ✔ | ✔ | ✔ | ✔ | - | ↑ | ↑ | Normal | Normal | N/↑ | Normal | ↓ | Normal | Auto antibodies present (Anti GAD-65 and anti insulin anti bodies) |
Type 2 Diabetes mellitus | ✔ | ✔ | ✔ | ✔ | - | ↑ | ↑ | Normal | Normal | ↑ | Normal | Normal | ↑ | Acanthosis nigricans |
MODY | ✔ | ✔ | ✔ | - | ✔ | ↑ | ↑ | Normal | Normal | ↑ | Normal | Normal | N | - |
Psychogenic polydipsia | ✔ | ✔ | - | - | - | Normal | Normal | Normal | ↓ | Normal | Normal | Normal | Normal | - |
Diabetes insipidus | ✔ | ✔ | - | - | - | Normal | Normal | Normal | ↑ | Normal | Normal | Normal | Normal | - |
Transient hyperglycemia | - | - | - | - | - | ↑ | ↑ | Normal | Normal | ↑ | Normal | Normal | N/↑ | In hospitalized patients especially in ICU and CCU |
Steroid therapy | ✔ | - | - | - | ✔ | ↑ | ↑ | Normal | Normal | ↑ | ↑ | N/↑ | N/↑ | Acanthosis nigricans |
RTA 1 | - | - | - | ✔ | - | Normal | Normal | ↑ | Normal | ↑ | Normal | Normal | Normal | Hypokalemia, nephrolithiasis |
Glucagonoma | - | - | - | - | - | ↑ | Normal | Normal | Normal | - | Normal | Normal | ↑ | Necrolytic migratory erythema |
Cushing syndrome | - | - | - | - | ✔ | ↑ | - | Normal | ↓ | N/↑ | ↑ | Normal | Normal | Moon face, obesity, buffalo hump, easy bruisibility |
References
- ↑ Barrett TG (2007). "Differential diagnosis of type 1 diabetes: which genetic syndromes need to be considered?". Pediatr Diabetes. 8 Suppl 6: 15–23. doi:10.1111/j.1399-5448.2007.00278.x. PMID 17727381.
- ↑ Type 1 Diabetes mellitus "Dennis Kasper, Anthony Fauci, Stephen Hauser, Dan Longo, J. Larry Jameson, Joseph Loscalzo"Harrison's Principles of Internal Medicine, 19e Accessed on December 27th,2016
- ↑ "namrata".