Differentiating Diabetes mellitus type 1 from other diseases
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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]
- Type 2 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
History and symptoms | Physical examination | Investigations | |||||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Polyuria | Polydipsia | Polyphagia | Weight loss | Weight gain | Positive medical history | General appearance | Skin manifestations | Serum glucose | Urinary Glucose | Urine Ph | Serum Sodium | Urinary Glucose | 24 hrs cortisol level | C-peptide level | Auto antibodies | Serum glucagon | |
Type 1 Diabetes mellitus | ✔ | ✔ | ✔ | ✔ | ✖ | Usually patients are young and lean | ― | ↑ | ↑ | N | N | ↑ | N | ↓ |
|
||
Type 2 Diabetes mellitus | ✔ | ✔ | ✔ | ✖ | ✔ | ✖ | Usually patients are middle age or elderly and obese | Acanthosis nigricans | ↑ | ↑ | N | N | ↑ | N | N | ― | N |
MODY | ✔ | ✔ | ✔ | ✔ | ✖ | ― | ― | ↑ | ↑ | N | N | ↑ | N | N | ― | N | |
Psychogenic polydipsia | ✔ | ✔ | ✖ | ✖ | ✖ | ✖ | ― | ― | N | N | N | ↓ | N | N | N | ― | N |
Diabetes insipidus | ✔ | ✔ | ✖ | ✖ | ✖ | ✖ | ― | ― | N | N | ↑ | N | N | N | ― | N | |
Transient hyperglycemia | N | ✖ | ✖ | ✖ | ✖ | ✔ | ― | ― | ↑ | ↑ | N | ↑ | N | N | ― | N | |
Steroid therapy | ✔ | ✖ | ✖ | ✖ | ✔ | ✔ | ― | Acanthosis nigricans | ↑ | ↑ | ↑ | ↑ | N | ― | N | ||
RTA 1 | ✖ | ✖ | ✖ | ✔ | ✖ | ✖ | ― | ― | N | ― | ↓ | ↑ | N | N | ― | N | |
Glucagonoma | ✖ | ✖ | ✖ | ✖ | ✖ | ✖ | ― | Necrolytic migratory erythema (NME) | ↑ | ― | N | N | ― | ↑ | |||
Cushing disease | ✖ | ✖ | ✖ | ✖ | ✔ | ✖ | Patients can present with moon face,
obesity and buffalo hump |
Acanthosis nigricans | ↑ | ― | N | N/↑ | ↑ | N | ― | N | |
Hypothyroidism | ✖ | ✖ | ✖ | ✖ | ✔ | ✖ | Patients may present with weight gain and swelling of face | ― | N | ― | N | N | N | N | Antibodies assocaited with hypothyroidism are:
|
N |
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".