A fifteen year old boy with insulin-dependent diabetes mellitus is brought to th

Question

A fifteen year old boy with insulin-dependent diabetes mellitus is brought to the ER by his father because of severe abdominal pain and vomiting for the past six hours. The father says that he has been complaining of mild stomach "cramps" and "thirst" for the past few days, but nothing this extreme. When the father leaves the room, the boy reluctantly admits that he has not been taking his insulin because he is mad at his parents for going away on a cruise and "leaving him" for five days. His blood pressure is 100/70 mmHg, pulse is 98/min, and respirations are 30/min. Physical examination shows dry skin and mucus membranes and diffuse abdominal pain. Laboratory studies show: Glucose: 675 mg/dL Sodium: 136 mEq/L Potassium: 6.0 mEq/L Chloride: 89 mEq/L Bicarbonate: 11 mEq/L For this patient, what is the most likely diagnosis? List the three types of diabetes and discuss the pathogenesis, treatment, and long-term sequelea for each type.

Explanation / Answer

The patient is a case of type 1 diabetes mellites. Since, he has not taken insulin for 5 days, his blood glucose levels have increased tremendously. Because of absence of insulin, body utilises fats as an energy source. Ketone bodies are formed as a byproduct of fat metabolism. So, the boy is suffering from diabetic ketoacidosis.

The three types of diabetes are,

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