Differentiating Diabetes mellitus type 1 from other diseases: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
Line 23: Line 23:


{| class="wikitable"
{| class="wikitable"
!
! rowspan="2" |Disease
! colspan="6" |History and symptoms
! colspan="5" |History and symptoms
!Physical examination
! colspan="8" |Laboratory findings
!
! rowspan="2" |Additional findings
!Investigations
!
!
!
!
!
!
!
!
|-
|-
!
!Polyuria
!Polyuria
!Polydipsia
!Polydipsia
Line 43: Line 33:
!Weight loss
!Weight loss
!Weight gain
!Weight gain
!Positive medical history
!General appearance
!Skin manifestations
!Serum glucose
!Serum glucose
!Urinary Glucose
!Urinary Glucose
!Urine Ph
!Urine PH
!Serum Sodium
!Serum Sodium
!Urinary Glucose
!Urinary Glucose
!24 hrs cortisol level
!24 hrs cortisol level
!C-peptide level
!C-peptide level
!Auto antibodies
!Serum glucagon
!Serum glucagon
|-
|-
!'''Type 1 Diabetes mellitus'''
|'''Type 1 Diabetes mellitus'''
!✔
|✔
!✔
|✔
!✔
|✔
!✔
|✔
!
|
!✖
|'''↑'''
!Usually patients are young and lean
|''''''↑''''''
!―
|Normal
!'''↑'''
|Normal
!'''↑'''
|
!N
|Normal
!N
|'''↓'''
!'''↑'''
|Normal
!N
|Auto antibodies present ([[GAD65|Anti GAD-65]] and anti insulin anti bodies)
!'''↓'''
!
* Measurements of IA2 autoantibodies within 6 months of diagnosis can help differentiate between type 1 and type 2 DM
* Anti-GAD65 usually present
* Anti-insulin autoantibodies usually present
!
|-
|-
|Type 2 Diabetes mellitus
|Type 2 Diabetes mellitus
Line 82: Line 62:
|✔
|✔
|✔
|✔
|✖
|✔
|✔
|✖
|
|Usually patients are middle age or elderly and obese
|'''↑'''
|Acanthosis nigricans
|'''↑'''
|'''↑'''
|Normal
|Normal
|'''↑'''
|'''↑'''
|N
|Normal
|N
|Normal
|'''↑'''
|'''↑'''
|N
|[[Acanthosis nigricans]]
|N
|―
|N
|-
|-
|MODY
|MODY
Line 101: Line 78:
|✔
|✔
|✔
|✔
|
| -
|✔
|✔
|✖
|―
|―
|'''↑'''
|'''↑'''
|'''↑'''
|'''↑'''
|N
|Normal
|N
|Normal
|'''↑'''
|'''↑'''
|N
|Normal
|Normal
|N
|N
|―
|―
|N
|-
|-
|Psychogenic polydipsia
|Psychogenic polydipsia
|✔
|✔
|✔
|✔
|✖
| -
|✖
| -
|✖
| -
|✖
|Normal
|―
|Normal
|―
|Normal
|N
|N
|N
|'''↓'''
|'''↓'''
|N
|Normal
|N
|Normal
|N
|Normal
|Normal
|―
|―
|N
|-
|-
|Diabetes insipidus
|Diabetes insipidus
Line 141: Line 112:
|✖
|✖
|✖
|✖
|✖
|Normal
|―
|Normal
|―
|Normal
|N
|N
|
|'''↑'''
|'''↑'''
|N
|Normal
|N
|Normal
|N
|Normal
|Normal
|―
|―
|N
|-
|-
|Transient hyperglycemia
|Transient hyperglycemia
|N
| -
|✖
| -
|✖
| -
|✖
| -
|✖
| -
|✔
|―
|―
|'''↑'''
|'''↑'''
|'''↑'''
|'''↑'''
|
|Normal
|N
|Normal
|'''↑'''
|'''↑'''
|N
|Normal
|N
|Normal
|―
|N/'''↑'''
|N
|In hospitalized patients especially in [[ICU]] and [[CCU]]
|-
|-
|Steroid therapy
|Steroid therapy
|✔
|✔
|✖
| -
|✖
| -
|✖
| -
|✔
|✔
|✔
|―
|Acanthosis nigricans
|'''↑'''
|'''↑'''
|'''↑'''
|'''↑'''
|
|Normal
|
|Normal
|'''↑'''
|'''↑'''
|'''↑'''
|'''↑'''
|N
|N/'''↑'''
|―
|N/'''↑'''
|N
|Acanthosis nigricans,
|-
|-
|RTA 1
|RTA 1
Line 198: Line 160:
|✔
|✔
|✖
|✖
|✖
|Normal
|―
|Normal
|―
|N
|―
|'''↓'''
|'''↓'''
|
|Normal
|'''↑'''
|'''↑'''
|N
|Normal
|N
|Normal
|Normal
|―
|―
|N
|-
|-
|Glucagonoma
|Glucagonoma
Line 217: Line 176:
|✖
|✖
|✖
|✖
|✖
|―
|Necrolytic migratory erythema (NME) 
|'''↑'''
|'''↑'''
|―
|Normal
|Normal
|Normal
|
|
|
|Normal
|
|Normal
|N
|N
|―
|'''↑'''
|'''↑'''
|Necrolytic migratory erythema
|-
|-
|Cushing disease
|Cushing syndrome
|✖
|✖
|✖
|✖
Line 236: Line 192:
|✖
|✖
|✔
|✔
|✖
|Patients can present with moon face,
obesity and buffalo hump
|Acanthosis nigricans
|'''↑'''
|'''↑'''
|―
|―
|
|Normal
|'''N'''
|'''↓'''
|N/'''↑'''
|N/'''↑'''
|'''↑'''
|'''↑'''
|N
|Normal
|―
|Normal
|N
|Patients can present with moon face,
obesity and buffalo hump
|-
|-
|Hypothyroidism
|Hypothyroidism
Line 256: Line 209:
|✖
|✖
|✔
|✔
|✖
|Normal
|Patients may present with weight gain and swelling of face
|Normal
|―
|Normal
|N
|Normal
|―
|Normal
|
|Normal
|'''N'''
|Normal
|N
|Normal
|N
|N
|Antibodies assocaited with hypothyroidism are:
|Antibodies assocaited with hypothyroidism are:
* Thyroid Peroxidase Antibody
* Thyroid Peroxidase Antibody
* Thyroglobulin Antibody
* Thyroglobulin Antibody
* Thyroid Stimulating Hormone Receptor Antibody  
* Thyroid Stimulating Hormone Receptor Antibody  
|N
|}
|}


Revision as of 16:47, 7 March 2017

Diabetes mellitus main page

Diabetes mellitus type 1 Microchapters

Home

Patient Information

Overview

Historical Perspective

Pathophysiology

Classification

Causes

Differentiating Diabetes mellitus type 1 from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural history, Complications, and Prognosis

Diagnosis

Diagnostic study of choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Dietary Management

Medical Therapy

Surgery

Strategies for Improving Care

Foundations of Care and Comprehensive Medical Evaluation

Diabetes Self-Management, Education, and Support
Nutritional Therapy

Glycemic Targets

Approaches to Glycemic Treatment

Cardiovascular Disease and Risk Management

Hypertension and Blood Pressure Control
Lipid Management
Antiplatelet Agents
Coronary Heart Disease

Microvascular Complications and Foot Care

Diabetic Kidney Disease
Diabetic Retinopathy
Diabetic Neuropathy
Diabetic Footcare

Older Adults with Diabetes

Children and Adolescents with Diabetes

Management of Cardiovascular Risk Factors in Children and Adolescents with Diabetes
Microvascular Complications in Children and Adolescents with Diabetes

Management of Diabetes in Pregnancy

Diabetes Care in the Hospital Setting

Primary Prevention

Future or Investigational Therapies

Case Studies

Case #1

Diabetes mellitus Main page

Patient Information

Type 1
Type 2

Overview

Classification

Diabetes mellitus type 1
Diabetes mellitus type 2
Gestational diabetes

Differential Diagnosis

Complications

Screening

Diagnosis

Prevention

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Type 1 DM must be differentiated from type 2 DM, MODY-DM, psychogenic polydipsia, diabetes insipidus, transient hyperglycemia, steroid therapy, renal tubular acidosis type-1, glucagonoma, cushing's syndrome, and hypothyroidism.

Differentiating Diabetes mellitus type 1 from other Diseases

Differential diagnosis of type 1 DM, include: [1][2][3]

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 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 ―
Glucagonoma ✖ ✖ ✖ ✖ ✖ ↑ Normal Normal Normal Normal Normal ↑ Necrolytic migratory erythema
Cushing syndrome ✖ ✖ ✖ ✖ ✔ ↑ ― Normal ↓ N/↑ ↑ Normal Normal Patients can present with moon face,

obesity and buffalo hump

Hypothyroidism ✖ ✖ ✖ ✖ ✔ Normal Normal Normal Normal Normal Normal Normal Normal Antibodies assocaited with hypothyroidism are:
  • Thyroid Peroxidase Antibody
  • Thyroglobulin Antibody
  • Thyroid Stimulating Hormone Receptor Antibody

References

  1. ↑ 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.
  2. ↑ 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
  3. ↑ "namrata".

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Differentiating_Diabetes_mellitus_type_1_from_other_diseases&oldid=1299065"