Differential Diagnosis for Diabetes Type 2
Single Most Likely Diagnosis
- Type 2 Diabetes Mellitus: This is the most likely diagnosis given the context, as it is the most common form of diabetes and is often associated with insulin resistance and impaired insulin secretion, typically in the setting of obesity and physical inactivity.
Other Likely Diagnoses
- Impaired Glucose Tolerance (IGT) or Impaired Fasting Glucose (IFG): These conditions are often precursors to type 2 diabetes and share similar risk factors. They are characterized by blood glucose levels that are higher than normal but not high enough to be classified as diabetes.
- Type 1 Diabetes Mellitus: Although less common than type 2, especially in adults, type 1 diabetes can present at any age and is characterized by an absolute deficiency of insulin production due to autoimmune destruction of the pancreatic beta cells.
- LADA (Latent Autoimmune Diabetes in Adults): This form of diabetes has characteristics of both type 1 and type 2 diabetes, with autoimmune antibodies present but often initially responsive to oral medications like type 2 diabetes.
- Steroid-Induced Diabetes: Prolonged use of corticosteroids can lead to insulin resistance and hyperglycemia, mimicking type 2 diabetes.
- Pancreatic Diabetes (Pancreatogenic Diabetes): Conditions affecting the pancreas, such as pancreatitis or pancreatic surgery, can lead to diabetes due to the loss of pancreatic tissue.
Do Not Miss Diagnoses
- Cushing's Syndrome: A rare endocrine disorder caused by excess cortisol, which can lead to insulin resistance and diabetes. Missing this diagnosis could lead to significant morbidity and mortality if not treated.
- Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodes of hypertension, tachycardia, and hyperglycemia due to excess catecholamine production.
- Acromegaly: A disorder caused by excess growth hormone, often due to a pituitary tumor, which can lead to insulin resistance and diabetes.
- Hypothyroidism: Although more commonly associated with hypoglycemia, severe hypothyroidism can occasionally present with hyperglycemia due to decreased glucose utilization and increased glucose production.
Rare Diagnoses
- MODY (Maturity-Onset Diabetes of the Young): A form of diabetes caused by genetic mutations that affect insulin production, typically presenting in young adulthood.
- Wolfram Syndrome: A rare genetic disorder characterized by diabetes insipidus, diabetes mellitus, optic atrophy, and deafness.
- Klinefelter Syndrome: A genetic condition in males that can increase the risk of developing insulin resistance and type 2 diabetes.
- Prader-Willi Syndrome: A rare genetic disorder that can lead to obesity and insulin resistance, increasing the risk of developing type 2 diabetes.