Chief Complaint:8-year-old girl with excessive thirst, frequent urination, and weight loss.

History: Lynn Thompson, an 8-year-old girl in previously good health, has noticed that, in the past month, she is increasingly thirsty. She gets up several times a night to urinate and finds herself gulping down a glass of water. At the dinner table, she seems to be eating twice as much as she used to, yet she has lost 5 pounds in the past month. In the past three days, she has become nauseated, vomiting on three occasions, prompting a visit to her pediatrician.

At the doctor’s office, blood and urine samples are taken. The following lab results are noted:

blood glucose level = 545 mg/dl
blood pH level = 7.23
(normal = 50 – 170 mg/dl)
(normal = 7.35 – 7.45)
urine = tested positive for glucose and for acetone / acetoacetate (i.e. ketone bodies) (normally urine is free of glucose and ketone bodies)

1- Why is the pH decreased in this patient?

2- List 5 differences between Diabetes Mellitus I and Diabetes Mellitus II.

3-  What is the biggest challenge a recently diagnosed diabetic patient like this one may face?


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