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Endocrine Case Study
Patient 1 The parents of an 11-year-old girl bring her for an office visit. She has been developing normally and has been healthy and active. Her parents report that for the past several weeks, she has been feeling tired and weak, drinking more fluids than normal, and has been urinating so much she has wet the bed at night. Two days ago, they noticed that her breath smelled like fruit and she lost 8 pounds these last weeks. Yesterday she began breathing fast and deep.
Initial Diagnosis
The symptoms presented are characteristics of early onset of type I diabetes with a secondary diagnosis of diabetic ketoacidosis (Wherrett et al., 2018). The patient presents with polydipsia and polyuria, classic symptoms of diabetes, and due to her age, these fit with type I diabetes. Her Kussmaul respirations combined with the fruity breath are indicators for diabetic ketoacidosis, typically seen in type I diabetes.
Pathophysiologic Explanation(s)
The patient is urinating more than usual due to the overworking of the kidneys. There are large amounts of sugar in the patients body, and the kidneys need to make more urine to pass out these extra amounts of sugar from the body. The kidney process results in more water being used up in the body, and the patient gets dehydrated fast, resulting in their increased consumption of fluids (Wherrett et al., 2018). The patient lacks enough insulting, meaning that glucose cannot be processed to enter the cells in the body for use as fuel. Therefore, the body and body cells lack enough energy leading to the patient feeling tired. The body is forced to break down fat to produce energy, causing the patient to lose weight.
Tests To Confirm the Diagnosis
The primary screening test for type I diabetes in children is a random blood sugar test. A blood sample is obtained from the patient at a random time (Wherrett et al., 2018). If the blood sugar level is 200 milligrams per deciliter (mg/dl) or higher the patient does have diabetes.
Glycated hemoglobin (A1C) test. An A1C test will indicate the patients average blood sugar level for the past three months. Diabetes is confirmed if the A1C level is 6.5 percent or higher on two separate tests.
Fasting blood sugar test. In this test, a blood sample is taken from the patient after they have fasted overnight. The test measures the patients blood sugar level after fasting. A fasting...…the patient. A random blood sugar level is done by drawing the patients blood at a random time. The patients random blood sugar level will be higher than 200 mg/dl. The second test to perform will be the A1C test. An A1C test will reveal the patients average blood sugar level of the past three months, and the lab result will demonstrate the patient has an A1C level greater than 6.5%. The patients fasting blood sugar test will indicate a level greater than 126 mg/dl (Bullard et al., 2018).
We would expect the patient to live for about 13 to 21 years with the condition from the patients age and symptoms. However, his quality of life might decrease if they do not take the recommendations given by the doctor seriously. Type 2 diabetes should not be a life-threatening condition, and people can live with it provided they take the necessary insulin shots and modify their lifestyles. Eating healthy meals and exercising will increase the life expectancy of the patient. The patients symptoms will decrease his life expectancy, and his quality of life will deteriorate. Retinal hemorrhages will cause blindness, meaning the patient becomes blind, and they have to learn to live…
References
Bullard, K. M., Cowie, C. C., Lessem, S. E., Saydah, S. H., Menke, A., Geiss, L. S., . . . Imperatore, G. (2018). Prevalence of diagnosed diabetes in adults by diabetes type—United States, 2016. Morbidity and Mortality Weekly Report, 67(12), 359.
Wherrett, D. K., Ho, J., Huot, C., Legault, L., Nakhla, M., & Rosolowsky, E. (2018). Type 1 diabetes in children and adolescents. Canadian journal of diabetes, 42, S234-S246.
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