Diabetic Ketoacidosis (DKA): Although the anion gap is not significantly elevated, the presence of hyperglycemia (glucose 121) and an anion gap of 17 could be indicative of early or mild DKA, especially if the patient has symptoms such as polyuria, polydipsia, or abdominal pain.

Lactic Acidosis: This condition can cause an elevated anion gap and may not always present with significantly abnormal other lab values initially. It can be due to various causes including intense exercise, sepsis, or biguanide (metformin) use.
Renal Tubular Acidosis (RTA): Certain types of RTA can present with a mild elevation in anion gap, though this is less common. The normal other lab values do not strongly support this diagnosis, but it remains a consideration.
Early or Mild Starvation Ketoacidosis: Similar to DKA, starvation ketoacidosis can cause an elevated anion gap metabolic acidosis. However, the glucose level is typically lower in starvation states.

Toxic Alcohol Ingestion (e.g., Methanol or Ethylene Glycol Poisoning): Although less likely given the relatively mild elevation in anion gap, these conditions can be fatal if not promptly diagnosed and treated. They often present with an osmolar gap in addition to an anion gap.
Sepsis: Sepsis can cause lactic acidosis, leading to an elevated anion gap. It's crucial to consider sepsis in any patient with unexplained metabolic acidosis, as it is a life-threatening condition.

Maple Syrup Urine Disease or Other Organic Acidemias: These are rare genetic disorders that can cause an elevated anion gap metabolic acidosis. They are more commonly diagnosed in pediatric patients but can present at any age if undiagnosed.
Ketoacidosis due to Other Causes (e.g., Alcoholic Ketoacidosis): While less common than DKA, other forms of ketoacidosis can present with an elevated anion gap and should be considered based on the patient's history and clinical presentation.