ETIOLOGIC DIAGNOSIS OF DIABETES MELLITUS IN ADULTS: QUESTIONS TO ASK, TESTS TO REQUEST
Beyond the two most common types of diabetes mellitus (type 1 and type 2), there are also numerous specific types of diabetes. They affect approximately 5 % of patients with diabetes mellitus, but this prevalence seems to be largely underestimated according to many studies. However, the etiologic diagnosis of diabetes is essential to treat a possible underlying disease, to tailor the antidiabetic treatment, and to better assess the prognosis and progression of diabetes. It is also useful to estimate the risk of relatives and their children, and to ensure an adapted prevention and care. This article proposes a clinical guide to properly conduct a systematic, targeted interview and clinical examination of patients diagnosed with diabetes mellitus, which can also be used to direct paraclinical investigations, if necessary. Through a consistent body of evidence, it is possible to establish an etiologic diagnosis of diabetes mellitus with the objective of providing better care.
KEYWORDS: diabetes mellitus; etiology; diagnosis; classification; diagnostic techniques and procedures
RELEVANCE OF THE ETIOLOGIC DIAGNOSIS OF DIABETES MELLITUS:
For more than twenty years, the positive diagnosis of diabetes mellitus (DM) has been clearly established by the World Health Organization. However, the etiologic diagnosis is often limited in everyday practice, as it only distinguishes between type 1 and type 2 diabetes. Yet, as shown in Table 1, which describes the classification of DM , there are widely different origins of chronic hyperglycemia: monogenic, pancreatic, endocrine, syndromic, etc. Upon discovery of DM, establishing an etiologic diagnosis according to this classification has significant importance for both patients and their relatives ...