Differential Diagnosis for EC
- Single most likely diagnosis
- Type 2 diabetes: This is the most likely diagnosis due to EC's symptoms of increased thirst and urination, presence of acanthosis nigricans, high BMI (93rd percentile), and family history of type 2 diabetes. Her laboratory results, including an A1C of 7.2% and blood glucose of 202 mg/dL, also support this diagnosis. The absence of autoantibodies and urine ketones further points away from type 1 diabetes.
- Other Likely diagnoses
- Prediabetes: Although EC's laboratory results are above the threshold for prediabetes, her symptoms and family history suggest that she may have already progressed to type 2 diabetes. However, prediabetes is still a consideration, especially if her lifestyle changes begin to show significant improvements in her glucose levels.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Diabetic ketoacidosis (DKA): Although EC's urine dip is negative for ketones, DKA is a potentially life-threatening condition that requires prompt recognition and treatment. It is essential to monitor EC's condition closely and be aware of the signs and symptoms of DKA, such as nausea, vomiting, abdominal pain, and rapid breathing.
- Type 1 diabetes: Although EC's autoantibody test is negative, and her clinical presentation is more suggestive of type 2 diabetes, it is crucial to consider type 1 diabetes, especially if her symptoms worsen or do not respond to treatment.
- Rare diagnoses
- MODY (Maturity-Onset Diabetes of the Young): This is a rare form of diabetes caused by genetic mutations. Although EC's family history of type 2 diabetes is significant, MODY could be considered if her diagnosis does not fit neatly into type 1 or type 2 diabetes, or if she has a strong family history of diabetes at a young age.
- Other rare forms of diabetes: Such as pancreatic diabetes or diabetes due to other endocrinopathies, although these are less likely given EC's clinical presentation and family history.