COVID-19-associated diabetes mellitus differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Tayyaba Ali, M.D.[2]

Overview

COVID-19-associated diabetes mellitus diagnosis should be differentiated from other diseases manifesting with polyuria, polydipsia, and hyperglycemia.

Differentiating COVID-19-associated diabetes mellitus 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[1] + + + + - ↑ ↑ Normal Normal N/↑ Normal ↓ Normal Auto antibodies present

(Anti GAD-65 and anti insulin anti bodies)

Type 2 Diabetes mellitus[1] + + + + - ↑ ↑ Normal Normal ↑ Normal Normal ↑ Acanthosis nigricans
Maturity onset diabetes of young[2] + + + - + ↑ ↑ Normal Normal ↑ Normal Normal N -
Psychogenic polydipsia[3] + + - - - Normal Normal Normal ↓ Normal Normal Normal Normal -
Diabetes insipidus[3] + + - - - Normal Normal Normal ↑ Normal Normal Normal Normal -
Transient hyperglycemia[4] - - - - - ↑ ↑ Normal Normal ↑ Normal Normal N/↑ In hospitalized patients especially in ICU and CCU
Steroid therapy[5] + - - - + ↑ ↑ Normal Normal ↑ ↑ N/↑ N/↑ Acanthosis nigricans,
RTA 1[6] - - - + - Normal Normal ↑ Normal ↑ Normal Normal Normal Hypokalemia, nephrolithiasis
Glucagonoma[7] - - - - - ↑ Normal Normal Normal - Normal Normal ↑ Necrolytic migratory erythema
Cushing syndrome[8] - - - - + ↑ - Normal ↓ N/↑ ↑ Normal Normal Moon face, obesity, buffalo hump, easy bruisibility
COVID-19-associated diabetes mellitus[9] + + - - - ↑ - - ↓ - - - - New onset diabetes in a patient infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)[10]
  • To browse the differential diagnosis of COVID-19, Click here.

References

  1. ↑ 1.0 1.1 "Diabetes Overview - Symptoms, Causes, Treatment".
  2. ↑ "Monogenic Diabetes (Neonatal Diabetes Mellitus & MODY) | NIDDK".
  3. ↑ 3.0 3.1 "Thirst - excessive: MedlinePlus Medical Encyclopedia".
  4. ↑ Harp JB, Yancopoulos GD, Gromada J (2016). "Glucagon orchestrates stress-induced hyperglycaemia". Diabetes Obes Metab. 18 (7): 648–53. doi:10.1111/dom.12668. PMC 5084782. PMID 27027662.
  5. ↑ Tamez-Pérez HE, Quintanilla-Flores DL, Rodríguez-Gutiérrez R, González-González JG, Tamez-Peña AL (2015). "Steroid hyperglycemia: Prevalence, early detection and therapeutic recommendations: A narrative review". World J Diabetes. 6 (8): 1073–81. doi:10.4239/wjd.v6.i8.1073. PMC 4515447. PMID 26240704.
  6. ↑ "Distal renal tubular acidosis: MedlinePlus Medical Encyclopedia".
  7. ↑ "Glucagonoma: MedlinePlus Medical Encyclopedia".
  8. ↑ "Cushing Syndrome | Hypercortisolism | MedlinePlus".
  9. ↑ Chee YJ, Ng SJH, Yeoh E (2020). "Diabetic ketoacidosis precipitated by Covid-19 in a patient with newly diagnosed diabetes mellitus". Diabetes Res Clin Pract. 164: 108166. doi:10.1016/j.diabres.2020.108166. PMC 7194589 Check |pmc= value (help). PMID 32339533 Check |pmid= value (help).
  10. ↑ Rubino F, Amiel SA, Zimmet P, Alberti G, Bornstein S, Eckel RH; et al. (2020). "New-Onset Diabetes in Covid-19". N Engl J Med. doi:10.1056/NEJMc2018688. PMC 7304415 Check |pmc= value (help). PMID 32530585 Check |pmid= value (help).
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