Case: D.K. is an 18-year-old high school student who began to experience weight loss despite a ravenous appetite and resulting increased dietary intake. She has to make frequent trips to the bathroom to urinate and has difficulty concentrating on her work because of fatigue. She drinks large volumes of coffee to help with a constant dry mouth and to combat her fatigue. At a clinic appointment, it was noted that D.K.’s weight has dropped from 140 to 128 pounds. She is 5 feet 7 inches tall. Her urine specimen shows glycosuria and ketonuria. A chemstick blood glucose level is 412 mg/dl. D.K. had eaten breakfast 3 hours before the chemstick blood test.
Question-1: Indicate what form of diabetes mellitus is the patient suffering from and explain why you chose that form.
From D.K.’s patient history and examination, many signs leading to the assumption of an insulin-related diabetes are present. We can note that D.K. has been experiencing increased levels of hunger, thirst and of course, urination. Additionally, she has had a rapid weight loss (from 140 lbs. to 128 lbs.) and continues to have fatigue and dry mouth, which she treats with coffee. D.K. has symptoms that correlate with diabetes mellitus type 1, which is known as an insulinopenia. Because D.K.’s glucose levels were above 412 mg/dl., it was appropriate to test for ketonuria, which ended up showing up positive. Additionally, D.K.’s glycosuria symptoms can arise from a hyperglycemia which could also relate to her dehydration and constant thirst. This special point can possibly suggest that she is having episodes of diabetic ketoacidosis. During the type of diabetes D.K. is displaying, the insulinopenia occurs due to her B cells being destroyed (an autoimmune situation) , hence not enough insulin is being produced, leading to decreased energy causing the fatigue
