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Case 2 A 13-year-old male student was seen by his primary care physician. His ch

ID: 149022 • Letter: C

Question

Case 2

A 13-year-old male student was seen by his primary care physician. His chief complaints were fatigue, weight loss, and increases in appetite, thirst, and frequent urination. The patient has a family history of diabetes mellitus. Chemistry and Urinalysis results are listed below:

Urinalysis Results

Chemistry Results

Specific Gravity

1.012

Fasting Plasma Glucose

160 mg/dL

Glucose

4+

Ketone

Large

   Based on the preceding information, can this patient be diagnosed with diabetes? Why or why not ? What are the two most common methods for measuring plasma glucose? What is the principle for each test?

List 2 additional tests (besides Fasting Plasma Glucose) that could be used to confirm diagnosis, and predict the results of each for this patient. Assuming this patient has diabetes, which type would be diagnosed? Why?

Urinalysis Results

Chemistry Results

Specific Gravity

1.012

Fasting Plasma Glucose

160 mg/dL

Glucose

4+

Ketone

Large

Explanation / Answer

Yes this patient can be diagnosed with diabetes. A person is said to be diabetic when the fasting blood glucose level is at or above 126mg/dl. In this case the patient's blood glucose level l under fasting condition is 160mg/dl, thus very clearly proving him to be diabetic.

The two most common method for measuring the plasma glucose are:-

1. Fasting blood sugar test- a blood sample is taken after an overnight fast. if it is more than 126 mg/dl person is diagnosed with diabetes.

Principle- Fasting allows the body to manage sugar. High level of blood sugar during fasting suggest that the body has been unable to lower the level of sugar in the blood. This points to either insulin resistance or inadequate insulin production in the body.

2. Post prandial (pp) blood glucose test- blood sample is taken exactly two hours after the meal. It determines the amount of a type of sugar after the meal.

Principle- At 2 hours after the meal, blood sugar level normally falls down in a normal person because the pancreas secretes insulin which assists the body in removing glucose and storing it for energy. But in diabetic person this level remain elevated. Thus it serves as a test for checking the diabetes.

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