Diabetes Type 1 Vs. Type 2: What Are The Differences? (2016, November 12). Retrieved from https://differencecamp.com/diabetes-type1-vs-type2-differences/.
Type 1 Diabetes Mellitus
This could be a differential for this patient. Type 1 DM is the destruction of beta cells by the body (autoimmune) over a period of time. There is an increase in gluconeogenesis, which increases hyperglycemia. The classic presentation of a patient with new onset Type 1 DM include; polydipsia, polyuria, polyphagia, weight loss, and fatigue. A patient presenting with Type 1 DM would have increased blood sugar and ketones in their urine. Type 1 DM typically presents itself in childhood, but has the potential to present in adults as well.
This patient does not have Type 1 DM because they have other risk factors that contribute to the diagnosis of Type 2 DM such as; hypertension and obesity. These are more frequently associated with Type 2 DM.
Cushing Syndrome/Disease
Cushing’s could also be a differential for this patient. Cushing Syndrome is caused by chronic exposure to increased cortisol. Cushing disease is the overproduction of ACTH. Patients with Cushing’s have weight gain and glucose intolerance. Cushing’s disease promotes an increase in gluconeogenesis and glycogen storage of the liver, which increases hyperglycemia. Patient’s with Cushing’s will also have polyuria due to hyperglycemia. Cushing’s is caused from cortisol secretion from a tumor on the adrenal gland.
This patient does not have Cushing’s Syndrome or Disease because he does not have a tumor present on his adrenal gland.
Barrell, A. (2018, January 4). Pancreas divisum: Treatment, management, and diet. Retrieved from https://www.medicalnewstoday.com/articles/320515.php.
Pancreatitis
Pancreatitis can also cause hyperglycemia. Pancreatitis is an acute disorder of the pancreas, causing epigastric or mid-abdominal pain. It is obstructive and causes the release of enzymes in the pancreatic acinar cells. This results in inflammation, which causes edema and pain. Pancreatitis causes transient hyperglycemia.
This patient does not have transient hyperglycemia, nor does he have epigastric or mid-abdominal pain.
Tumor of the Adrenal Medulla
Another differential could be a tumor of the adrenal medulla. A pheochromocytoma of the adrenal medulla can cause hypertension, excessive production of norepinephrine, release of catecholamines, and glucose intolerance. The glucose intolerance occurs from catecholamine-induced reduction of insulin release from the pancreas. This usually occurs in response to stressors or specific activities.
This patient does not have a pheochromocytoma and they do not have exercise induced glucose intolerance.
References
Barrell, A. (2018, January 4). Pancreas divisum: Treatment, management, and diet. Retrieved from https://www.medicalnewstoday.com/articles/320515.php.
Diabetes Type 1 Vs. Type 2: What Are The Differences? (2016, November 12). Retrieved from https://differencecamp.com/diabetes-type1-vs-type2-differences/.
McCance, K. L., Huether, S. E., Brashers, V. L., & Rote, N. S. (2018). Pathophysiology: the biologic basis for disease in adults and children. St. Louis, MO: Elsevier.