Case Studies 3 & 4
Suggested Reading Material
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Review the case study and answer all questions
Pagana: Mosby’s Manual of Diagnostic and Laboratory Tests, 6th Edition
Adolescent With Diabetes Mellitus (DM)
Case Studies
The patient, a 16-year-old high-school football player, was brought to the emergency room in a
coma. His mother said that during the past month he had lost 12 pounds and experienced
excessive thirst associated with voluminous urination that often required voiding several times
during the night. There was a strong family history of diabetes mellitus (DM). The results of
physical examination were essentially negative except for sinus tachycardia and Kussmaul
respirations.
Studies
Serum glucose test (on admission), p. 227
Arterial blood gases (ABGs) test (on admission),
p. 98
pH
PCO2
HCO2
Serum osmolality test, p. 339
Serum glucose test, p. 227
2-hour postprandial glucose test (2-hour PPG), p.
230
Glucose tolerance test (GTT), p. 234
Fasting blood glucose
30 minutes
1 hour
2 hours
3 hours
4 hours
Glycosylated hemoglobin, p. 238
Diabetes mellitus autoantibody panel, p. 186
insulin autoantibody
islet cell antibody
glutamic acid decarboxylase antibody
Microalbumin, p. 872
Results
1100 mg/dL (normal: 60–120 mg/dL)
7.23 (normal: 7.35–7.45)
30 mm Hg (normal: 35–45 mm Hg)
12 mEq/L (normal: 22–26 mEq/L)
440 mOsm/kg (normal: 275–300
mOsm/kg)
250 mg/dL (normal: 70–115 mg/dL)
500 mg/dL (normal:
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