Analysis of Missed Diagnosis and Misdiagnosed Causes of Patients with Type 2 Diabetes Mellitus

ZHANG Jin; ZHANG Jian-jun; ZHANG Miao; WU Feng; WEI Li

doi:10.3969/j.issn.1002-3429.2017.05.013

Abstract：Objective To summarize missed diagnosis and misdiagnosed causes of patients with type 2 diabetes mellitus.Methods clinical data of 13 missed diagnosis or misdiagnosed patients with type 2 diabetes mellitus during January 2015 and April 2016 was retrospectively analyzed.Results Missed diagnosis and misdiagnosed rate in this group was 15.12%.Among the 4 misdiagnosed patients, 3 patients visited doctors for waist pain associated by both lower extremities numbness, and were misdiagnosed as having lumbar intervertebral disc protrusion;1 visited doctor for foot ulcers without incentives, and was misdiagnosed as having vasculitis, The misdiagnosed time was 2-7 d.Among the 9 missed diagnosis patients, 4 patients were misdiagnosed as having cholecystitis because of fever, abdominal pain associated by nausea and vomiting;3 patients were misdiagnosed as having urinary infection because of urinary frequency, urgency and urodynia;2 patients were misdiagnosed as having eczema complicated with infection because of skin rash, itching and flare in both lower extremities.The missed diagnosis time was 2 d-6 months.All patients were confirmed the diagnosis of type 2 diabetes mellitus after fasting blood glucose, 2 h postprandial blood glucose and glycosylated hemoglobin examinations, and were treated with controlling blood glucose and corresponding support treatment.Misdiagnosed patients' conditions significantly improved, while missed diagnosis patients had no recrudescence.Conclusion Diabetes mellitus is easily missed diagnosis or misdiagnosed because of atypical symptoms induced by complex complications, and therefore clinicians should comprehensively understand the related knowledge and its complications, carefully ask disease history and perform comprehensive examination so as to confirm diabetes mellitus as early as possible to avoid occurrence of missed diagnosis and misdiagnosis.