Factitious disorder presenting as type 1 diabetes mellitus

Area of Science:

• Psychiatry
• Internal Medicine
• Medical Ethics

Background:

• Factitious disorder (FD) is characterized by the intentional production of illness symptoms to assume the sick role without external incentives.
• FD presents diagnostic challenges for clinicians and can lead to severe health consequences and societal costs.
• Misdiagnosis of FD can result in inappropriate treatments and delayed recognition of the underlying psychological condition.

Purpose of the Study:

• To describe a case of factitious disorder presenting as type 1 diabetes mellitus.
• To highlight the diagnostic difficulties associated with factitious disorder.
• To emphasize the importance of accurate diagnosis in managing factitious disorder.

Main Methods:

• Case report of a middle-aged man with factitious disorder.
• Clinical presentation mimicking type 1 diabetes mellitus.
• Recurrent episodes of hypoglycemia as a key symptom.

Main Results:

• The patient presented with recurrent hypoglycemic episodes suggestive of poorly controlled diabetes.
• Factitious disorder was identified as the underlying cause, not type 1 diabetes.
• The intentional production of illness symptoms was key to the diagnosis.

Conclusions:

• Factitious disorder can manifest with symptoms mimicking endocrine disorders like diabetes.
• Early and accurate diagnosis of FD is crucial to prevent iatrogenic harm and unnecessary healthcare utilization.
• Clinicians should maintain a high index of suspicion for FD in complex or unexplained cases.