Identify any abnormal laboratory values measured upon his admission. Explain how they may be related to his newly diagnosed DM
What will be an ideal response?
• HbA1c = 10.2% (high): Due to a chronic state of hyperglycemia. The more glucose in the blood, the more glucose that is glycated to the protein hemoglobin. HbA1c represents the average blood glucose over a period of about 3 months.
• Glucose = 550 mg/dL (high): Hyperglycemia due to lack of insulin.
• CO2 (high): Due to DKA; an indirect measure of acidity.
• Blood and urinary pH (low): metabolic acidosis due to elevated ketone levels
• Osmolality (high): Due to dehydration and hyperglycemia.
• Phosphate (low): Electrolyte imbalance associated with dehydration or with kidney function.
• Sodium (low): Due to dehydration and an electrolyte imbalance from DKA.
• Triglycerides (high): Altered fat metabolism due to type 1 diabetes.
• Cholesterol and LDL (high): Abnormal lipid profile.
• HDL (low): Abnormal lipid profile
• Ketones/protein/glucose in urine: Due to kidney's inability to prevent large molecules from spilling over into the urine. Due to hyperglycemia from type 1 diabetes; >180 mg/dL blood glucose values allow these to spill into the urine, which is abnormal.
• Low c-peptide: Confirms that pancreas is not producing adequate amounts of insulin.
• Antibodies ICA, IAA, GADA: Confirm autoimmune attack on beta cells consistent with T1DM.
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A) ?25% B) ?31% C) ?43% D) ?51%
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