38-year-old female with excessive thirst, frequent urination, and weight loss. H

Question

38-year-old female with excessive thirst, frequent urination, and weight loss. History: Cindy Mallon, a 38 year old Caucasian female in previously good health, she 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 glassfuls of water. At the dinner table, she seems unusually hungry, yet she has lost 5 pounds in the past month. In the past three days, she has felt lethargic and had noted some visual changes where her vision is blurry. QUESTIONS: At the doctor's office, blood and urine samples are taken.

The following lab results are noted:

• blood glucose level = 445 mg/dl (normal = 50 - 170 mg/dl)

• blood pH level = 7.40 (normal = 7.35 -7.45)

• urine = tested positive for glucose and negative for acetone / acetoacetate (i.e. ketone bodies)

1) At the office, you examine her and notice that she has a dark pigmented ring around her neck and is considered to be morbidly obese. The pigmentation is called acanthosis nigricans and is sometimes noted with metabolic disorders. Do those signs have to do with her current condition?

2) What are the possible long-term complications of her disease?

Explanation / Answer

1. Acanthosis nigricans is a dark skin pigmentation , due to diabetes and being overweight. Since the lady was suffering from type 2 diabetes, higher level of insulin will be found in her bloodstream that leads to higher growth of skin epidemaepcells and deposutibnof melanin.

2. Long term complications of type 2 diabetes includes kidney damage , heart disease, diabetic retinopathy , stroke or kidney disease and amputation of limbs.

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