Question

17. A 5 year old girl displayed increased appetite, increased urinary frequency, and thirst. Her physician suspected new onset diabetes mellitus and confirmed that she had elevated urine glucose and ketones. ABG's revealed: (2) pH 7.33 HCM:12 mmol/ pCO;: 21 mmHg a. What is most likely diagnosis for this patient? b. What is most likely the cause of the low pH?

Answer 1

1) Diagnosis,  

A) Random blood sugar test - blood sample taken at any time. Regardless of when you last, ate a random blood sugar level of 200 milligrams per deci litre or higher suggests diabetes

B) Fasting blood sugar test - blood sample is taken after an overnight fast . A fasting blood sugar level less than 100 mg / dl is normal , between 100-125 mg/dL is pre-diabetes , and above 126 mg/ dL on two separate test, then diabetes.

C) Oral glucose tolerance test - for this fasting over night and then fasting blood glucose is measured. Then you drink sugary liquid , blood sugar level are measured periodically for next two hours. Reading of 200 mg/dl indicates diabetes.

2) low pH is there in diabetes. The lower pH is due to combination of greater NAE and lower use of ammonia buffers in patient with diabetes , which predisposes them to uric acid urolithiasis.