Question

Pateints weight was 62 kg, and her BMI was 21 kg/m2 .Her fingerstick glucose on admission was 571 mg/dl, and subsequently measured serum glucose was 617 mg/dl. Testing revealed a sodium level of 133 mEq/l (normal 135–145), potassium of 4.0 mEq/l (normal 3.5–5.0), chloride of 99 mEq/l (normal 96–108), carbon dioxide of 25 mEq/l (normal 21–30), blood urea nitrogen (BUN) of 18 mg/dl (normal 7.0–20.0), and creatinine of 0.8 mg/ dl (normal 0.4–10). Serum acetone was positive at 1:2. Urinalysis revealed a specific gravity of 1.010 (normal 1.005–1.300), glucose of 3+, ketones of 2+, and pH of 5.5 (normal 5.0–8.0), with other results normal.Normal osmolality ranges for urine and serum are 500-800 mOsm/kg H2O and 285-295 mOsm/kg H2O, respectively. Given the above laboratory tests, your understanding of SGLT1 and saturation mechanics, are her urine and serum values high or low? Explain your reasoning.

Answer 1

The osmolality ranges for urine and serum will increase in their levels with an increase in plasma glucose concentration.The patient has increases levels of glucose in both blood and serum results.So the patient has diabetes which clearly shows an increase in osmolality.It depends on the individuals hydration status.