Differentiating Diabetes mellitus type 2 from other diseases: Difference between revisions
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[[Image:Home_logo1.png|right|250px|link=https://www.wikidoc.org/index.php/Diabetes_mellitus_type_2]] | |||
{{CMG}};{{AE}}{{MehdiP}} | {{CMG}};{{AE}}{{MehdiP}} | ||
==Overview== | ==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) | [[Diabetes mellitus type 2|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. [[Diabetes mellitus type 1|type 1 DM]], [[Maturity onset diabetes of the young|MODY]]), other [[Endocrine system|endocrine]] disorders (e.g. [[hypothyroidism]], [[cushing's syndrome]], [[wolfram syndrome]], [[alstrom syndrome]]) or drug-related disorders. | ||
==Differentiating Diabetes Mellitus Type 2 from other Diseases== | ==Differentiating Diabetes Mellitus Type 2 from other Diseases== | ||
* [[Diabetes mellitus type 2|Type 2 DM]] must be differentiated from other forms of [[diabetes mellitus]] as well as other [[Endocrine system|endocrine]] disorders based on the symptoms and [[laboratory]] findings.<ref name="pmid17727381">{{cite journal| author=Barrett TG| title=Differential diagnosis of type 1 diabetes: which genetic syndromes need to be considered? | journal=Pediatr Diabetes | year= 2007 | volume= 8 Suppl 6 | issue= | pages= 15-23 | pmid=17727381 | doi=10.1111/j.1399-5448.2007.00278.x | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17727381 }}</ref><ref>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</ref><ref>{{Cite web|url=http://www.namrata.co/diabetes-mellitus-differential-diagnosis-and-management/|title=namrata|last=|first=|date=|website=|publisher=|access-date=}}</ref> The following table shows the appropriate history and [[Symptom|symptoms]], and [[laboratory]] findings that may distinguish [[Diabetes mellitus type 2|type 2 DM]] from other diseases: | |||
{| style="border: 0px; font-size: 90%; margin: 3px;" align=center | {| style="border: 0px; font-size: 90%; margin: 3px;" align="center" | ||
! rowspan="2" align="center" style="background:#DCDCDC;"|Disease | ! rowspan="2" align="center" style="background:#DCDCDC;" |Disease | ||
! colspan="5" align="center" style="background:#DCDCDC;"|History and symptoms | ! colspan="5" align="center" style="background:#DCDCDC;" |History and symptoms | ||
! colspan="8" align="center" style="background:#DCDCDC;"|Laboratory findings | ! colspan="8" align="center" style="background:#DCDCDC;" |Laboratory findings | ||
! rowspan="2" align="center" style="background:#DCDCDC;"|Additional findings | ! rowspan="2" align="center" style="background:#DCDCDC;" |Additional findings | ||
|- | |- | ||
!align="center" style="background:#DCDCDC;"|[[Polyuria]] | ! align="center" style="background:#DCDCDC;" |[[Polyuria]] | ||
!align="center" style="background:#DCDCDC;"|[[Polydipsia]] | ! align="center" style="background:#DCDCDC;" |[[Polydipsia]] | ||
!align="center" style="background:#DCDCDC;"|[[Polyphagia]] | ! align="center" style="background:#DCDCDC;" |[[Polyphagia]] | ||
!align="center" style="background:#DCDCDC;"|[[Weight loss]] | ! align="center" style="background:#DCDCDC;" |[[Weight loss]] | ||
!align="center" style="background:#DCDCDC;"|[[Weight gain]] | ! align="center" style="background:#DCDCDC;" |[[Weight gain]] | ||
!align="center" style="background:#DCDCDC;"|[[Serum glucose]] | ! align="center" style="background:#DCDCDC;" |[[Serum glucose]] | ||
!align="center" style="background:#DCDCDC;"|Urinary Glucose | ! align="center" style="background:#DCDCDC;" |Urinary [[Glucose]] | ||
!align="center" style="background:#DCDCDC;"|Urine PH | ! align="center" style="background:#DCDCDC;" |Urine [[PH]] | ||
!align="center" style="background:#DCDCDC;"|[[Sodium|Serum Sodium]] | ! align="center" style="background:#DCDCDC;" |[[Sodium|Serum Sodium]] | ||
!align="center" style="background:#DCDCDC;"|Urinary Glucose | ! align="center" style="background:#DCDCDC;" |Urinary [[Glucose]] | ||
!align="center" style="background:#DCDCDC;"|24 hrs [[cortisol]] level | ! align="center" style="background:#DCDCDC;" |24 hrs [[cortisol]] level | ||
!align="center" style="background:#DCDCDC;"|[[C-peptide]] level | ! align="center" style="background:#DCDCDC;" |[[C-peptide]] level | ||
!align="center" style="background:#DCDCDC;"|Serum [[glucagon]] | ! align="center" style="background:#DCDCDC;" |Serum [[glucagon]] | ||
|- | |- | ||
|style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Diabetes mellitus type 1|Type 1 Diabetes mellitus]] | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Diabetes mellitus type 1|Type 1 Diabetes mellitus]] | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''''↑''''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''''↑''''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↓''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↓''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Auto antibodies present ([[GAD65|Anti GAD-65]] and anti insulin | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Auto-antibodies present ([[GAD65|Anti GAD-65]] and anti [[insulin]] antibodies) | ||
|- | |- | ||
|style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Diabetes mellitus type 2|Type 2 Diabetes mellitus]] | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Diabetes mellitus type 2|Type 2 Diabetes mellitus]] | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Acanthosis nigricans]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Acanthosis nigricans]] | ||
|- | |- | ||
|style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[MODY]] | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[MODY]] | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |N | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |N | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|- | |- | ||
|style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Psychogenic polydipsia]] | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Psychogenic polydipsia]] | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↓''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↓''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|- | |- | ||
|style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Diabetes insipidus]] | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Diabetes insipidus]] | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |- | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |- | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |- | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|- | |- | ||
|style="padding: 5px 5px; background: #DCDCDC;" align="center" |Transient [[hyperglycemia]] | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |Transient [[hyperglycemia]] | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |In hospitalized patients especially in [[ICU]] and [[CCU]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |In hospitalized patients especially in [[ICU]] and [[CCU]] | ||
|- | |- | ||
|style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Steroid]] therapy | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Steroid]] therapy | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Acanthosis nigricans|Acanthosis nigricans]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Acanthosis nigricans|Acanthosis nigricans,]] | ||
|- | |- | ||
|style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[RTA|RTA 1]] | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[RTA|RTA 1]] | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Hypokalemia]], [[nephrolithiasis]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Hypokalemia]], [[nephrolithiasis]] | ||
|- | |- | ||
|style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Glucagonoma]] | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Glucagonoma]] | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Necrolytic migratory erythema]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Necrolytic migratory erythema]] | ||
|- | |- | ||
|style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cushing's syndrome|Cushing syndrome]] | | style="padding: 5px 5px; background: #DCDCDC;" align="center" |[[Cushing's syndrome|Cushing syndrome]] | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | + | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | | style="padding: 5px 5px; background: #F5F5F5;" align="center" | - | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↓''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↓''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |N/'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |'''↑''' | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |Normal | ||
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Moon face]], [[obesity]], [[buffalo hump]], easy [[Bruising|bruisibility]] | | style="padding: 5px 5px; background: #F5F5F5;" align="center" |[[Moon face]], [[obesity]], [[buffalo hump]], easy [[Bruising|bruisibility]] | ||
|} | |} | ||
==References== | ==References== | ||
Latest revision as of 20:12, 1 August 2020
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Seyedmahdi Pahlavani, M.D. [2]
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), other endocrine disorders (e.g. hypothyroidism, cushing's syndrome, wolfram syndrome, alstrom syndrome) or drug-related disorders.
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 based on the symptoms and laboratory findings.[1][2][3] 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 antibodies) |
| 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".