A 37 year old man attended his GP\'s office for a routine pre-employment physica

Question

A 37 year old man attended his GP's office for a routine pre-employment physical following a long period working as a bookkeeper from home. He is Caucasian and on examination appeared in relatively good health, though reported an increase in snoring which was disrupting his sleep. His BMI was 29.4 (92kg) and blood pressure was 130/85. The following biochemistry results were obtained. Plasma Urine Result 140 mmol/L 133-143 3.8 mmol/L 3.6-4.6 25 mmol/L 24-32 105 mmol/L 98-108 5.2 mmol/L 3.0-7.0 40 mmH 125 umol/L 60-120 Reference Range Result Negative Negative Reference Range Dipstick Protein Blood Albumin/Creatinine 0.010g/g

Explanation / Answer

The diagnosis is Diabetes mellitus. Diabetic mellitus is a metabolic disorder characterized by elevated levels of blood glucose levels. It is of two types :-

-Type 1= due to deficency of insulin

-Type 2= due to resistance to insulin

Sign and symptoms are:-

- polyphagia

-polyphagia

- polyuria

- weakness

-weight loss

- delayed healing

- blurred vision

- dizziness

- lightheadedness

High glucose levels affects the kidneys and cause osmotic diuresis. This leads to increased loss of glucose in the urine. Water follows glucose and leads to increased urine output and cause increased thirst.

Dipstick glucose test is a test in which urine is assessed for protein by using a dipstick. The dipstick is introduced into the patients urine and then analysis is made on the basis of comparing with the colour coding present on the label of box.

Colour changes from yellow to green. It is done to find the Percentage of kidney damage occurred due to diabetes mellitus. The values are:-

Trace react - 5-20mg/ dl

+1 - 30mg/dl

+2 -100mg/dl

+3 - 300mg/dl

+4 -1000mg/dl

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