8 Health Conditions Mistaken for Type 2 Diabetes

Diabetes affects every part of the body, causing symptoms like fatigue, weight gain, mood changes, and neuropathic pain, among others. These symptoms are not unique to diabetes: They are also common in other conditions, such as hypothyroidism, metabolic syndrome, and Cushing’s syndrome.

If you experience any of these symptoms, it’s important to speak with a healthcare provider. It could be a sign that you need to change your diabetes treatment plan or address an unrelated condition.

Hypothyroidism occurs when the thyroid gland, a butterfly-shaped organ that helps regulate your metabolism, doesn’t produce enough thyroid hormone. It can lead to symptoms like extreme fatigue, weight gain, and mood changes — all of which are also symptoms of diabetes.

“While these two conditions carry overlapping symptoms, many people with type 1 or type 2 diabetes also develop hypothyroidism,” says Egils Bogdanovics, MD, a diabetes and metabolism endocrinologist at Charlotte Hungerford Hospital in Torrington, Connecticut. “For this reason, annual thyroid screenings are recommended.”

Metabolic syndrome is not one health condition; it is a group of risk factors that can contribute to a higher risk of type 2 diabetes and cardiovascular diseases like heart attack, heart failure, and stroke.

• Excess fat around the abdomen
• High blood sugar levels
• High blood pressure
• Low levels of HDL ("good") cholesterol
• High triglyceride levels

“Metabolic syndrome shares the same causes as type 2 diabetes,” says Dr. Bogdanovics. “Type 2 diabetes and cardiovascular disease can develop due to the same underlying issues, including high triglycerides, high blood pressure, low HDL cholesterol, and obesity.”

Type 2 diabetes and metabolic syndrome require similar treatment strategies, including lifestyle changes and medication.

“What looks like insulin resistance can be misdiagnosed as type 2 diabetes when you actually have type 1,” says Aimée José, RN, CDCES, a diabetes educator in private practice in the San Diego area. “If you don’t present with typical risk factors of type 2 diabetes, like challenges with your weight and a sedentary lifestyle, push for testing to rule out type 1 diabetes.”

If you are following all of your doctor’s diabetes treatment recommendations but still can’t keep your blood sugar on target and continue to experience the symptoms of hyperglycemia, it may be worth asking your doctor to confirm your diagnosis.

Polycystic ovary syndrome (PCOS) is a common hormonal condition that develops when the ovaries produce higher than normal levels of male hormones known as androgens.

“Due to the insulin resistance, PCOS can actually increase a woman’s risk of developing type 2 diabetes,” says Bogdanovics. “Some women also develop hyperpigmentation on the nape of their neck, also known as acanthosis nigricans.”

“We also consider possible Cushing’s syndrome in any person with type 2 diabetes who requires abnormally high doses of insulin,” says Bogdanovics. “Most cases of Cushing’s syndrome go unrecognized.”

Pancreatitis can resemble diabetes because both conditions involve the death or dysfunction of the cells in the pancreas that produce insulin, leading to overlapping symptoms.

“Broadly speaking, pancreatitis is about inflammation of the pancreas, but there are multiple potential causes,” Bogdanovics says. These can include gallstones, heavy alcohol use, high triglyceride levels, certain medications, and injury.

Treatment varies depending on the cause. Taking pain medication and receiving intravenous fluids can ease symptoms, whereas other strategies, such as gallbladder surgery and limiting or quitting alcohol use, address the underlying cause.

Hemochromatosis is a hereditary condition involving the gradual buildup of iron in the body. When iron levels rise high enough, iron overload can result in uncomfortable symptoms, such as joint pain and fatigue.

“In the 1700s, physicians would actually taste a patient’s urine if they presented with frequent urination and constant thirst,” says Bogdanovics. “They tasted the urine because it would taste sweet if it’s diabetes mellitus or tasteless if it’s diabetes insipidus because it’s essentially pure water.”

• Conditions like hypothyroidism, metabolic syndrome, and Cushing’s syndrome can provoke signs and symptoms that are similar to those of diabetes. These overlapping features include fatigue, weight gain, and insulin resistance.
• Many conditions that mimic diabetes, such as PCOS, hypothyroidism, and Cushing’s syndrome, share insulin resistance as a defining feature. The most common cause of insulin resistance is obesity.
• Conditions like pancreatitis and hemochromatosis have symptoms that mimic common diabetes symptoms, but the underlying causes are significantly different.
• Because the complications of diabetes overlap with those of so many other conditions, it’s important to get any new symptoms checked out by your doctor.