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

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! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;"|Additional findings
! rowspan="2" align="center" style="background:#4479BA; color: #FFFFFF;"|Additional findings
|-
|-
!align="center" style="background:#4479BA; color: #FFFFFF;"|[[Polyuria]]
!align="center" style="background:#4479BA; color: #FFFFFF;"|Polyuria
!align="center" style="background:#4479BA; color: #FFFFFF;"|[[Polydipsia]]
!align="center" style="background:#4479BA; color: #FFFFFF;"|Polydipsia
!align="center" style="background:#4479BA; color: #FFFFFF;"|[[Polyphagia]]
!align="center" style="background:#4479BA; color: #FFFFFF;"|Polyphagia
!align="center" style="background:#4479BA; color: #FFFFFF;"|[[Weight loss]]
!align="center" style="background:#4479BA; color: #FFFFFF;"|Weight loss
!align="center" style="background:#4479BA; color: #FFFFFF;"|[[Weight gain]]
!align="center" style="background:#4479BA; color: #FFFFFF;"|Weight gain
!align="center" style="background:#4479BA; color: #FFFFFF;"|Serum glucose
!align="center" style="background:#4479BA; color: #FFFFFF;"|Serum glucose
!align="center" style="background:#4479BA; color: #FFFFFF;"|Urinary Glucose
!align="center" style="background:#4479BA; color: #FFFFFF;"|Urinary Glucose
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|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 anti bodies)
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |Auto antibodies present ([[GAD65|Anti GAD-65]] and anti insulin anti bodies)
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |-
|-
|style="padding: 5px 5px; background: #DCDCDC;" align="center" |Type 2 Diabetes mellitus
|style="padding: 5px 5px; background: #DCDCDC;" align="center" |Type 2 Diabetes mellitus
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |✔
|style="padding: 5px 5px; background: #F5F5F5;" align="center" |✔
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|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: #F5F5F5;" align="center" |-
|-
|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" |✔
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|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" |-
|-
|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" |✔
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|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: #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" |✔
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|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: #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" | -
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|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: #F5F5F5;" align="center" |-
|-
|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" |✔
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|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: #F5F5F5;" align="center" |-
|-
|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" | -
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|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: #F5F5F5;" align="center" |-
|-
|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" | -
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|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: #F5F5F5;" align="center" |-
|-
|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" | -

Revision as of 17:32, 7 March 2017

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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]

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

  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".

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