Identify any abnormal laboratory values measured upon her admission. Explain how they may be related to her newly diagnosed T1DM

Question

What will be an ideal response?

Answer 1

Chemistry Normal Value Rachel's Value Reason for Abnormality
Osmolality 285-295 mmol/kg/H2- 295.3 mmol/kg/H2- Slightly hyperosmolar due to hyperglycemia and resulting dehydration
Glucose 70-99 mg/dL 683 mg/dL Hyperglycemia due to insulin deficiency
Sodium 136-145 mEq/L 126 mEq/L Electrolyte imbalance due to hyperglycemia and resulting intracellular fluid shifts
Phosphate 2.2-4.6mg/dL 1.9 mg/dL Electrolyte imbalance due to hyperglycemia and resulting intracellular fluid shifts
HbA1C 3.9-5.2% 14.6% Indicative of hyperglycemia over the previous 120 days
C-peptide 0.51-2.72 ng/mL 0.10 ng/mL Indicates that there is inadequate endogenous insulin synthesis
ICA --- + Presence of autoantibodies indicates autoimmune destruction of beta-cells
GADA --- + Presence of autoantibodies indicates autoimmune destruction of beta-cells
IA-2A --- + Presence of autoantibodies indicates autoimmune destruction of beta-cells
IAA --- + Presence of autoantibodies indicates autoimmune destruction of beta-cells
pH of urine 5-7 4.9 Acidic due to presence of ketones in urine
Protein, glucose, ketones in urine neg + All are present in urine due to the response to hyperglycemia; serum blood glucose of >180 mg/dL results in loss of glucose in the urine; protein and ketones are indicative of the increased rates of gluconeogenesis and lipolysis