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
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".