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Misdiagnosis of Type 2 diabetes

Misdiagnosis of Type 2 diabetes

Type 2 diabetes can easily be overlooked because symptoms often develop slowly and may not be noticed for years. Symptoms when they do occur, such as fatigue, may be vague and can easily be ignored or attributed to other less serious causes.

However, regular medical care can quickly and efficiently screen for the disease. Type 2 diabetes can be diagnosed during a routine office visit using a combination of history, physical exam, and simple tests, such as a fasting blood glucose test, random blood glucose test, and urinanalysis performed on urine. The newest form of testing for type 2 diabetes is the glycated hemoglobin (A1C) test, which measures the average overall blood sugar for the past several months....more about Type 2 diabetes »

Alternative diagnoses list for Type 2 diabetes:

For a diagnosis of Type 2 diabetes, the following list of conditions have been mentioned in sources as possible alternative diagnoses to consider during the diagnostic process for Type 2 diabetes:

Diseases for which Type 2 diabetes may be an alternative diagnosis

The other diseases for which Type 2 diabetes is listed as a possible alternative diagnosis in their lists include:

Type 2 diabetes: Hidden Causes Misdiagnosed?

Causes of Type 2 diabetes may include these medical conditions:

Rare Types of Type 2 diabetes:

Type 2 diabetes: Medical Mistakes

Related medical mistakes may include:

Type 2 diabetes: Undiagnosed Conditions

Commonly undiagnosed conditions in related areas may include:

In-Depth Reports: Diagnosis and Misdiagnosis

Diabetes diagnosis and misdiagnosis (In-Depth Report): Detailed report on diabetes misdiagnoses, rare curable types, and less common diagnostic full report »

Common Misdiagnoses and Type 2 diabetes

Metabolic syndrome often undiagnosed: Metabolic syndrome, also known as Syndrome X, is an often overlooked medical condition that causes a cluster of chronic symptoms. There are often four symptoms and conditions combined: obesity, hypertension (high blood pressure), high cholesterol, and diabetes (Type 2 diabetes) or in come cases pre-diabetes initially. See the introduction to metabolic syndrome.

Heart attacks can be undiagnosed: Although the most severe symptoms of heart attack are hard to miss, there are varying degrees of severity. It is altogether too common for people to die from undiagnosed heart attack, or from delaying too long to call for emergency help. The prognosis for treatment is far better for patients treated in the early stages of a heart attack. The most common misdiagnoses include heartburn, or other less severe causes of chest pain. See the introduction to heart attack and the symptoms of heart attack.

Heart attacks can be overdiagnosed: Although many people die from heart attacks, there are also many cases where people fear that they have a heart attack, but actually have something milder. Some of the conditions which may be causes of chest pain, causing fear of a heart attack, including an anxiety attack, heartburn, and so on. See the causes of chest pain and the symptoms of heart attack.

Undiagnosed causes of weight gain and obesity: Although obesity may be related to lifestyle issues, there are also a number of medical causes of weight gain or obesity that may go undiagnosed. Some of the various possibilities include thyroid disorders (i.e. hypothyroidism), polycystic ovarian syndrome (i.e. PCOS), and various other causes of weight gain. Metabolic syndrome with its related diabetes (Type 2 diabetes) is also a consideration, although possibly less helpful in terms of treatment. See also misdiagnosis of obesity or causes of weight gain.

Rare undiagnosed iron disorder causes various severe conditions: The rare "iron overload" disorder, hemochromatosis, can cause a variety of symptoms and result in various severe conditions that mimic several of the big name medical conditions. However, since it is quite rare (about 1 in 200 to 1 in 300), it may go undiagnosed, and indeed doctors may not even test for it. It can damage the pancreas, causing pancreatitis, leading to diabetes-like symptoms. It can damage the liver, leading to liver symptoms such as jaundice. Hemochromoatis can also damage the joints, giving the appearance of arthritis. The heart is another organ that excess iron can damage. Fortunately, this condition has a relatively simple treatment, and these complications can often be reversed by treatment of the iron overload causing them. See introduction to hemochromatosis.

Cluster of diseases with difficult diagnosis issues: There is a well-known list of medical conditions that are all somewhat difficult to diagnose, and all can present in a variety of different severities. Diseases in this group include multiple sclerosis, lupus, Lyme disease, fibromyalgia, thyroid disorders (hypothyroidism or hyperthyroidism), chronic fatigue syndrome, diabetes - all of these can have vague symptoms in their early presentations. Also, depression can have some symptoms similar to these conditions, and also the reverse, that many of these conditions can mimic depression and be misdiagnosed as depression.

Alzheimer's disease over-diagnosed: The well-known disease of Alzheimer's disease is often over-diagnosed. Patients tend to assume that any memory loss or forgetulness symptom might be Alzheimer's, whereas there are many other less severe possibilities. Some level of memory decline is normal with aging, and even a slight loss of acuity may be noticed in the 30's and 40's. Other conditions can also lead a person to show greater forgetfulness. For example, depression and depressive disorders can cause a person to have reduced concentration and thereby poorer memory retention.

Dementia may be a drug interaction: A common scenario in aged care is for a patient to show mental decline to dementia. Whereas this can, of course, occur due to various medical conditions, such as a stroke or Alzheimer's disease, it can also occur from a side effect or interaction between multiple drugs that the elderly patient may be taking. There are also various other possible causes of dementia.

Rare type of breast cancer without a lump: There is a less common form of breast cancer called inflammatory breast cancer. Its symptoms can be an inflammation of the breast tissue, such as with a breast rash with redness and warmth, but not necessarily a physical breast lump. This type of breast cancer should be considered as an uncommon possibility for certain types of breast symptoms.

Tremor need not be Parkinson's disease: There is the tendency to believe that any tremor symptom, or shakiness, means Parkinson's disease. The reality is that there are various possibilities, such as benign essential tremor, which is mostly harmless. see the various causes of tremor and misdiagnosis of Parkinson's disease.

Poorly healing leg rashes a classic sign of chronic disease: Recurring leg rashes, or poorly healing leg rashes, are a classic sign of undiagnosed diabetes, particularly of Type 2 diabetes, but also Type 1 diabetes. They can also occur with poor diabetic control. However, there are many other possible causes of leg rashes. See causes of leg rash or misdiagnosis of diabetes.

Leg cramps at night a classic sign: The symptom of having leg muscle cramps, particularly at night, is a classic sign of undiagnosed diabetes. However, there are also various other causes. See causes of leg cramps or misdiagnosis of diabetes.

Rare diseases misdiagnosed as Parkinson's disease: A rare genetic disorder is often misdiagnosed as Parkinson's disease for men in their 50's. The disease Fragile X disorder can show only mild symptoms in the early years, and Parkinsons-like symptoms around age 50. See misdiagnosis of Parkinson's disease.

Over-diagnosis of pulmonary hypertension in obese patients: A diagnosis of pulmonary hypertension, particularly pulmonary arterial hypertension, is often a misdiagnosis in obese patients. Exertional dyspnea leads to a diagnostic reading of high right ventricular systolic pressure, which seems to indicate pulmonary hypertension, but is ultimately found to be an incorrect diagnosis. See misdiagnosis of pulmonary hypertension.

Obesity-related conditions undiagnosed in children: A variety of conditions are associated with obesity (see obesity), but these tend to be undiagnosed more often in child patients than in adults. Some of the overlooked conditions may include hypertension, diabetes, acanthosis nigricans, etc. See misdiagnosis of obesity or introduction to obesity.

Misdiagnosed weight-related causes of infertility: A woman's weight status can affect her level of fertility. Although obesity or overweight can in themselves reduce fertility, there are other weight-related or associated medical conditions that further reduce fertility. Some of these hidden causes include COPD, diabetes, thyroid disorders (overactive thyroid or underactive thyroid) and metabolic syndrome. See also other causes of infertility.

Type 2 diabetes: Rare Types

Rare types of medical disorders and diseases in related medical areas:

Failure To Diagnose Type 2 diabetes

Failure to diagnose Type 2 diabetes may be associated with the following:

  • MODY diabetes is often undiagnosed as suffers are usually thin and relatively young
  • Undiagnosed or poorly-controlled diabetes can lead to complications such as: hyperglycemia, ketoacidosis, hypoglycemia and diabetic coma
  • Long term high insulin levels increases the risk of premature hardening of the arteries
  • Undiagnosed or poorly-controlled diabetes can cause eye damage (diabetic retinopathy) which can result in reduced vision or even blindness
  • Undiagnosed or poorly-controlled diabetes can cause kidney disease (diabetic nephropathy) which can result in kidney damage or even kidney failure in severe cases
  • Undiagnosed or poorly-controlled diabetes can cause nerve damage (diabetic neuropathy) which can result in peripheral neuropathy (pain, tingling, buzzing, loss of sensation in hands and feet). Nerve damage can also lead to loss of bladder control, impotence, erectile dysfunction or even leave a person unable to walk
  • Undiagnosed or poorly-controlled diabetes can cause foot ulcers which can become infected and in some cases ultimately require amputation
  • Undiagnosed or poorly-controlled diabetes can cause cognitive problems leading to premature memory problems and dementia - especially in the elderly. It is believed that it also increases the risk of Alzheimer's disease.
  • Undiagnosed or poorly-controlled diabetes results in poor circulation which can lead to various skin and blood vessel problems
  • Undiagnosed or poorly-controlled diabetes can cause digestive problems such as nausea, vomiting and diarrhea
  • Undiagnosed or poorly-controlled diabetes can cause poor control of heart rate and blood pressure during changes in posture (e.g. when standing up)
  • Poorly controlled or undiagnosed diabetes can result in an increased risk of infections such as pneumonia, tuberculosis, mucocutaneous candidiasis, staphylococcal infections, cystitis and pyelonephritis
  • Poorly controlled or undiagnosed diabetes can also cause depression, sleep apnea, neuropathic joint damage and tendon rupture

Notes On Hidden Causes Of Type 2 diabetes

The following may be hidden causes of Type 2 diabetes:

  • Genetic factors can cause type 2 diabetes
  • Factors associated with type 2 diabetes includes: high fat diet, high sugar diet, excessive alcohol consumption, lack of exercise, age, race, family history, giving birth to a high birth weight baby, gestational diabetes, polycystic ovarian syndrome and cardiovascular disease
  • African-Americans, Native Americans, Hispanic-Americans, Pacific Islander, Asian-American, Afro-Caribbeans, Aboriginal, Torres Strait Islanders, Chinese and Indian subcontinent people face a greater risk of diabetes
  • Acute illness, medical stress and surgical stress may be hidden causes of secondary diabetes

Complications Of Misdiagnosis Of Type 2 diabetes

The following may be complications of misdiagnosis of Type 2 diabetes:

  • A person who does not fit the profile for a particular type of diabetes may be diagnosed with the wrong type of diabetes and hence appropriate treatment is not received and the patient's health may suffer as a result
  • Vision problems (blurred vision, impaired vision) may be misdiagnosed as allergy or even simply as an independent eye problem
  • Nerve problems caused by diabetes may be misdiagnosed as neuropathic disorders such as cauda equina lesion, lumbosacral plexopathy and, autonomic neuropathy
  • Vulvovaginitis, pruritus vulae and balanitis may be diagnosed as a simple Candida albicans infection but it may in fact be a result of diabetes
  • A staphylococcal skin may be a diagnosed as an isolated skin infection whereas it may in fact be a complication of undiagnosed diabetes
  • Impotence may be a diagnosed as an isolated sexual dysfunction condition whereas it may in fact be a complication of undiagnosed diabetes
  • Increased urination associated with type 2 diabetes may be diagnosed as a urinary infection

Other Notes On Misdiagnosis Of Type 2 diabetes

  • Classification of type 2 diabetes by measuring fasting basal plasma glucose level
  • Mild: <140 mg/dL Insulin rarely needed, managed through diet and exercise
  • Moderate: 140-250 mg/dL Basal insulin therapy, usually needed as well as diet and exercise
  • Severe: >250 mg/dL Insulin regimen is required daily
  • Very severe: >250-300 mg/dL Treatment same as for type 1 diabetes
  • Treatment plans need to be regularly monitored as glucose control can deteriorate even with treatment or may improve substantially
  • Pregnant women who suffer gestational diabetes are more likely to develop type 2 diabetes later in life
  • Long periods of hypoglycemia can cause brain damage, coma or even death
  • Nerve damage due to diabetes can cause loss of sensation and hence it is important to regularly check the feet for ulcers or sores that can become infected
  • Diabetics have a reduced ability to fight infection and are thus more susceptible to conditions such as pneumonia, influenza, bacterial and fungal infections
  • Various factors can exacerbate diabetes: stroke, heart attack, pregnancy, surgery, trauma, infection, increase in weight, endocrine disease, reduced exercise and certain drugs
  • Type 2 diabetes has an insidious onset compared to type 1 which has a rapid onset
  • Many type 2 diabetics are asymptomatic
  • Acute illness, trauma and surgery may temporarily increase blood sugar levels which can lead to a misdiagnosis of diabetes

Medical news summaries about misdiagnosis of Type 2 diabetes:

The following medical news items are relevant to misdiagnosis of Type 2 diabetes:

Misdiagnosis and Type 2 diabetes deaths

Type 2 diabetes is a condition that can possibly be deadly if misdiagnosed...more »

General Misdiagnosis Articles

Read these general articles with an overview of misdiagnosis issues.

About misdiagnosis:

When checking for a misdiagnosis of Type 2 diabetes or confirming a diagnosis of Type 2 diabetes, it is useful to consider what other medical conditions might be possible misdiagnoses or other alternative conditions relevant to diagnosis. These alternate diagnoses of Type 2 diabetes may already have been considered by your doctor or may need to be considered as possible alternative diagnoses or candidates for misdiagnosis of Type 2 diabetes. For a general overview of misdiagnosis issues for all diseases, see Overview of Misdiagnosis.


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