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Case Study: Type 1 Diabetes Mellitus (DM1) David Mandel was diagnosed with type 1 (insulin-dependent) diabetes mellitus when he was 12 years old. He was in middle school at that time. He was a very good student and had many friends. At a sleepover party, the unimaginable happened – David wet his sleeping bag! He was embarrassed and might not have told his parents except that he was worried about other symptoms he was having. He was constantly thirsty and was urinating every half hour or so. Furthermore, despite a voracious appetite, he seemed to be losing weight – all of his pants had become loose in the waist. His friends remarked that his breath smelled funny. David’s parents panicked because they knew that these were classic symptoms of diabetes mellitus. They took David to see his pediatrician who performed a physical examination and ordered laboratory tests. RESULTS: Height: 5ft 3in Weight: 100 lb (previous visit 2 months earlier he was 108 lbs) Blood pressure: 90/55 (supine); 75/45 (standing) Fasting plasma glucose: 320 mg/dL (normal: 70-110 mg/dL) Plasma ketones: 1+ (normal: none) Urinary glucose: 4+ (normal: none) Urinary ketones: 2+ (normal: none) The findings were consistent with a diagnosis of type 1 (insulin-dependent) diabetes mellitus. David immediately started taking injectable insulin and learned how to monitor his blood glucose level with a finger stick. His mother modified his diet to increase protein intake and decrease carbohydrates. He continued to excel in high school and is currently in the pre-medical program with the goal of a career in pediatric endocrinology. He has periodic checkups with his endocrinologist, who emphasizes the importance of meticulous care of the feet, checks for cataracts, and monitors his renal function.

Case Study: Type 1 Diabetes Mellitus (DM1)

David Mandel was diagnosed with type 1 (insulin-dependent) diabetes mellitus when he was 12 years old. He was in middle school at that time. He was a very good student and had many friends. At a sleepover party, the unimaginable happened – David wet his sleeping bag! He was embarrassed and might not have told his parents except that he was worried about other symptoms he was having. He was constantly thirsty and was urinating every half hour or so. Furthermore, despite a voracious appetite, he seemed to be losing weight – all of his pants had become loose in the waist. His friends remarked that his breath smelled funny. David’s parents panicked because they knew that these were classic symptoms of diabetes mellitus. They took David to see his pediatrician who performed a physical examination and ordered laboratory tests.

RESULTS:
Height: 5ft 3in
Weight: 100 lb (previous visit 2 months earlier he was 108 lbs)
Blood pressure: 90/55 (supine); 75/45 (standing)
Fasting plasma glucose: 320 mg/dL (normal: 70-110 mg/dL)
Plasma ketones: 1+ (normal: none)
Urinary glucose: 4+ (normal: none)
Urinary ketones: 2+ (normal: none)

The findings were consistent with a diagnosis of type 1 (insulin-dependent) diabetes mellitus. David immediately started taking injectable insulin and learned how to monitor his blood glucose level with a finger stick. His mother modified his diet to increase protein intake and decrease carbohydrates. He continued to excel in high school and is currently in the pre-medical program with the goal of a career in pediatric endocrinology. He has periodic checkups with his endocrinologist, who emphasizes the importance of meticulous care of the feet, checks for cataracts, and monitors his renal function.

Added by Denise D.

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