Diabetes mellitus, Type 2 DIAGNOSIS

DIFFERENTIAL DIAGNOSIS


  • Type 1 diabetes mellitus
  • Other specific types of diabetes mellitus
    - Genetic defects of β -cell function
    - Genetic defects in insulin action
    - Diseases of exocrine pancreas
    - Endocrinopathies
    - Drug or chemical induced (see below)
    - Infections
    - Immune mediated
    - Genetic syndromes sometimes associated with diabetes
    - Hemochromatosis
  • Gestational diabetes mellitus

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LABORATORY


  • Criteria for diagnosis; any one is sufficient
    - Symptoms of diabetes (polyuria, polydipsia, weight loss) plus casual (random) plasma glucose - 200 mg/dL (11.1 mmol/L)
    - Fasting plasma glucose ≥ 126 mg/dL (7.0 mmol/L) on 2 occasions
    - 2 hour plasma glucose ≥ 200 mg/dL (11.1 mmol/L) during OGTT with 75 g glucose load

Drugs that may alter lab results:


  • Pentamidine
  • Nicotinic Acid
  • Glucocorticoids
  • Thyroid hormone
  • Diazoxide
  • Beta adrenergic agonists
  • Thiazides
  • Dilantin
  • Alpha-interferon
  • Some fluoroquinolones
  • Some second generation (atypical) antipsychotics

Disorders that may alter lab results: See Differential Diagnosis

PATHOLOGICAL FINDINGS N/A

SPECIAL TESTS


  • Glucose tolerance test usually not necessary, except when diagnosing gestational diabetes
  • Hemoglobin A1C not recommended for diagnosis, but helpful in management

IMAGING N/A

DIAGNOSTIC PROCEDURES N/A

Aug 09, 06 • Type 2 diabetes