Features of differential diagnosis of diabetes mellitus in the modern world: clinical observation

• Tatyana Yu. Demidova
• Elena Yu. Gritskevich
• Mar'yam Ya. Izmaylova

Abstract

In this review, a clinical case of diabetes in a young patient demonstrates atypical diseases and diagnostic difficulties. Diabetes mellitus is a heterogeneous group of diseases characterized by persistently elevated blood glucose levels. Although diabetes mellitus type 1 (T1DM) and type 2 (T2DM) are the most common types, other forms of diabetes often go undiagnosed or can be misdiagnosed as T1DM or T2DM. The clinical picture of diabetes mellitus may be atypical; the diagnosis of diseases may require additional examinations using diagnostic diagnostics and verification of the diagnosis of the type of diabetes mellitus.

Keywords:diabetes mellitus type 2, diabetes mellitus type 1, diagnostics, MODY-diabetes

REFERENCES

1. Chellappan D.K., Sivam N.S., Teoh K.X., Leong W.P., Fui T.Z., Chooi K., et al. Gene therapy and type 1 diabetes mellitus. Biomed Phar-macother. 2018; 108: 1188-200. DOI: https://doi.org/10.1016/j.bi-opha.2018.09.138 Epub 2018 Oct 2. PMID: 30372820.

2. Elksnis A., Martinell M., Eriksson O., et al. Heterogeneity of metabolic defects in type 2 diabetes and its relation to reactive oxygen species and alterations in beta-cell mass. Front. Physiol. 2019; 10: 107. DOI: https://doi.org/10.3389/fphys.2019.00107.

3. Shestakova M.V., Vikulova O.K., Zheleznyakova A.V., et al. Diabetes epidemiology in Russia: what has changed over the decade? Terapevticheskiy arkhiv [Therapeutic Archive]. 2019; 91 (10): 4-13. (in Russian)

4. Corbin K.D., Driscoll K.A., Pratley R.E., Smith S.R., Maahs D.M., Mayer-Davis E.J. Advancing Care for Type 1 Diabetes and Obesity Network (ACT1ON), obesity in type 1 diabetes: pathophysiology, clinical impact, and mechanisms. Endocr Rev. 2018; 39 (5): 629-63. DOI: https://doi.org/10.1210/er.2017-00191

5. Regnell S.E., Lernmark A. Early prediction of autoimmune (type 1) diabetes. Diabetologia. 2017; 60 (8): 1370-81. DOI: https://doi.org/10.1007/s00125-017-4308-1 Epub 2017 May 26.

6. Ilonen J., Lempainen J., Veijola R. The heterogeneous pathogenesis of type 1 diabetes mellitus. Nat Rev Endocrinol. 2019; 15 (11): 635-50. DOI: https://doi.org/10.1038/s41574-019-0254-y Epub 2019 Sep 18. PMID: 31534209.

7. Nishimura A., Matsumura K., Kikuno S., Nagasawa K., Okubo M., Mori Y., et al. Slowly progressive type 1 diabetes mellitus: current knowledge and future perspectives. Diabetes Metab Syndr Obes. 2019; 12: 2461-77. DOI: https://doi.org/10.2147/DMSO.S191007

8. Standards of specialized diabetes care. Edited by Dedov I.I., Shestakova M.V., Mayorov A. Yu. 9^th edition, suppl. Sakharniy diabet [Diabetes Mellitus]. 2019; 22 (1): 1-144. DOI: https://doi.org/10.14341/DM221S1 (in Russian)

9. Van der Tuin K., Hannema S.E., Houdijk E.C., Losekoot M., de Koning E.J., Breuning M.H. Erfelijke ouderdomsdiabetes bij jongeren [Maturity-onset diabetes of the young]. Ned Tijdschr Geneeskd. 2015; 159: A9247. [in Dutch]

10. Diabetes Control and Complications Trial Research Group; Nathan D.M., Genuth S., Lachin J., Cleary P., Crofford O., Davis M., et al. The effect of intensive treatment of diabetes on the development and progression of long-term complications in insulin-dependent diabetes mellitus. N Engl J Med. 1993; 329 (14): 977-86. DOI: https://doi.org/10.1056/NEJM199309303291401

11. Nathan D.M., Cleary P.A., Backlund J.Y., et al.; Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study Research Group. Intensive diabetes treatment and cardiovascular disease in patients with type 1 diabetes. N Engl J Med. 2005; 353: 2643-53.

12. Merger S.R., Kerner W., Stadler M., Zeyfang A., Jehle P., MQller-Korbsch M., et al.; DPV Initiative; German BMBF Competence Network Diabetes Mellitus. Prevalence and comorbidities of double diabetes. Diabetes Res Clin Pract. 2016; 119: 48-56. DOI: https://doi.org/10.1016/j.diabres.2016.06.003 Epub 2016 Jun 25.

13. Khawandanah J. Double or hybrid diabetes: a systematic review on disease prevalence, characteristics and risk factors. Nutr Diabetes. 2019; 9 (1): 33. DOI: https://doi.org/10.1038/s41387-019-0101-1

14. Triolo T.M., Armstrong T.K., McFann K., Yu L., Rewers M.J., KLingen-smith G.J., et at. Additional autoimmune disease found in 33% of patients at type 1 diabetes onset. Diabetes Care. 2011; 34 (5): 1211-3. DOI: https://doi.org/10.2337/dc10-1756

15. Bowden S.A., Hoffman R.P. Triple diabetes: coexistence of type 1 diabetes mellitus and a novel mutation in the gene responsible for MODY 3 in an overweigth adolescent. Pediatr Diabetes. 2008; 9 (2): 162-4. DOI: https://doi.org/10.1111/j.1399-5448.2007.00335.x

16. Malik F.S., Taplin C.E. Insulin therapy in children and adolescents with type 1 diabetes. Paediatr Drugs. 2014; 16 (2): 141-50. DOI: https://doi.org/10.1007/s40272-014-0064-6

17. Fattah H., Vallon V. The potential role of SGLT2 inhibitors in the treatment of type 1 diabetes mellitus. Drugs. 2018; 78 (7): 717-26. DOI: https://doi.org/10.1007/s40265-018-0901-y

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