Diabetes Mellitus Type 1: Or something else? Differential Diagnosis

Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99).

  • Genetic lipodystrophy including lipatrophic diabetes.
  • Hereditary neuromuscular diseases.
  • Mendenhall syndrome – group of extreme insulin-resistant syndromes (together with leprechaunism, the lipodystrophies and insulin resistance syndromes type A and B); Mendenhall syndrome has an autosomal recessive mode of inheritance: growth retardation starting already intrauterin (“in utero”)
  • Myotonic dystrophy
  • Laurence-Moon-Biedl-Bardet syndrome (LMBBS) – rare genetic disorder; according to clinical symptoms is divided into:
    • Laurence-Moon syndrome (without polydactyly, i.e., without the appearance of supernumerary fingers or toes, and obesity, but with paraplegia (paraplegia) and muscle hypotonia/reduced muscle tone) and
    • Bardet-Biedl syndrome (with polydactyly, obesity and peculiarities of the kidneys).
  • Prader-Willi syndrome (PWS; synonyms: Prader-Labhard-Willi-Fanconi syndrome, Urban syndrome and Urban-Rogers-Meyer syndrome) – genetic disorder with autosomal dominant inheritance, occurring in approximately 1: 10,000 to 1: 20,000 births; characteristic features include. Among other things, a pronounced overweight in the absence of a sense of satiety, short stature and intelligence reduction; in the course of life, diseases such as diabetes mellitus type 2 occur due to obesity.
  • Werner syndrome – (English adult progeria) – autosomal recessive disease, especially mesodermal tissue, which leads to a massive aging process (progeria), which begins around midlife.

Endocrine, nutritional and metabolic diseases (E00-E90).

  • Other forms of diabetes mellitus:
    • Special form: late onset autoimmune diabetes mellitus.
    • Type 2 diabetes (circa 90%), with and without obesity.
    • MODY (Maturity Onset Diabetes of the Young) [genetic defects of β-cell function] – typical constellation: Young slender patients (< 25 years) with positive family history of diabetes, who are antibody negative; insidious onset of the disease and no occurrence of ketoacidosis (form of metabolic acidosis (metabolic acidosis), which is particularly common as a complication of diabetes mellitus in the presence of absolute insulin deficiency; causative is too high a concentration of ketone bodies in the blood)
    • Gestational diabetes (> 1%)
  • DIDMOAD syndrome (synonym: Wolfram syndrome) – genetic disease with autosomal recessive inheritance; symptom complex with diabetes mellitus, diabetes insipidus (hormone deficiency-related disorder in hydrogen metabolism leading to extremely high urine excretion (polyuria; 5-25 l/day) due to impaired concentration capacity of the kidneys), optic atrophy (tissue atrophy (atrophy) of the optic nerve/optic nerve), sensorineural hearing loss.
  • Diabetes mellitus triggered by infections such as infection with the rubella virus (eg, congenital rubella, CMV infection).
  • Endocrinopathies (disease of endocrine glands with disruption of hormone production or regulation).
    • Acromegaly (giant growth)
    • Aldosteronomic (synonym: Conn’s disease) – form of primary hyperaldosteronism. It is characterized by overproduction of aldosterone in the adrenal cortex due to an adenoma (benign tumor) without activation by the renin-angiotensin-aldosterone system (RAAS).
    • Cushing’s syndrome (synonym: Cushing’s disease) – group of diseases leading to hypercortisolism (hypercortisolism) (excess of cortisol).
    • Glucagonom – hormonally active tumor of the pancreas, which produces the metabolically active hormone glucagon, which has a strong influence on the sugar balance of the body; it serves to provide glucose (glucose).
    • Hemochromatosis (iron storage disease) – genetic disease with autosomal recessive inheritance with increased deposition of iron as a result of increased iron concentration in the blood with tissue damage.
    • Hyperthyroidism (hyperthyroidism).
    • Pheochromocytoma – usually benign (benign) tumor (about 90% of cases), which originates mainly from the adrenal gland and can lead to hypertension crises (hypertensive crisis).
    • Somatostatinoma – hormone-active tumor that can occur in the endocrine pancreas (pancreas), as well as in the duodenum (duodenum); it produces somatostatin; this inhibits the secretion of pancreatic enzymes, gastrin and pepsin.
  • Cystic fibrosis (synonyms: CF (fibrosis cystica); Clarke-Hadfield syndrome (cystic fibrosis); cystic fibrosis) – genetic disorder with autosomal recessive inheritance characterized by the production of mucus in various organs that is too tame. It is the most common autosomal recessive inherited metabolic disease among Caucasians.

Liver, gallbladder, and bile ducts – Pancreas (pancreas) (K70-K77; K80-K87).

Neoplasms – tumor diseases (C00-D48).

Psyche – nervous system (F00-F99; G00-G99)

  • Stiff-man syndrome (SMS; synonyms: Stiff-person syndrome, SPS; Moersch-Woltman syndrome); neurologic disorder characterized by a generalized increase in tone of the muscles; in addition, spasms occur spontaneously or triggered in the affected muscles; usually the back and hip muscles are affected symmetrically; Gait becomes stiff-legged and bizarre; many have insulin-requiring diabetes mellitus (30%), autoimmune thyroiditis (autoimmune disease leading to chronic inflammation of the thyroid gland; 10%), atrophic gastritis (gastritis) with pernicious anemia (vitamin B12 deficiency anemia (anemia); 5%).

Pregnancy, childbirth, and puerperium (O00-O99).

Medication

  • See “Causes” under medications

Environmental pollution – intoxications (poisoning).

  • Rodenticide – chemical agent against rodents.