A 50-Year-Old Woman Comes to the Physician Due to Concerns

A 50-year-old woman comes to the physician due to concerns about having diabetes mellitus . She has not been to work since yesterday due to mild fatigue and dizziness for the past 2 days. She says she has "very high blood sugar" and has had similar episodes often in the past 2 years, for which she has visited multiple doctors around the city. She has also purchased a home glucose monitoring device, which she uses daily. Since the symptoms began, she has become socially withdrawn and spends much of her time at home researching diabetes on the internet. One week ago, she took a day off work because of her symptoms. She is not on any treatment. She has had three laboratory test reports that all show normal fasting and post-meal blood glucose levels. Her father and brother have type 2 diabetes mellitus. She appears anxious. Vital signs are normal. Physical examination shows no abnormalities. Random serum glucose is 128 mg/dL. Which of the following is the most likely explanation for this patient's symptoms? Which of the following is the most likely diagnosis?

A) Adjustment disorder with anxiety
B) Conversion disorder
C) Delusional disorder (somatic subtype)
D) Factitious disorder
E) Generalized anxiety disorder
F) Illness anxiety disorder
G) Somatic symptom disorder