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Type 1 Diabetes " Steve a 24-year-old man with frequent urination "

Case study ( 13938 views as of November 21, 2024 )

Steve, a 24-year-old man presents with frequent urination, thirst, fatigue, blurred vision and a weight loss of 18 pounds over the preceding 3 months. He claims he has been drinking a lot of sugar-containing soda drinks lately. There is no family history of diabetes.

On physical examination, he is very thin with decreased body fat and some muscle wasting. His blood sugar is elevated to 36 mmol/L, which is extremely high and likely indicates Type 1 diabetes. There is no anion gap (acidosis) documented with his electrolytes and creatinine (kidney function) are normal with urinary ketones being trace positive.

Steve needs medication to lower his blood glucose levels immediately. He needs to see an Endocrinologist who can make a proper diagnosis and decide whether he needs oral agents or insulin treatment. Steve should also see a Diabetic Nurse Educator to learn about diabetes, self-monitoring blood glucose levels, how to inject insulin properly if needed and the prevention and treatment of low blood sugars.

Steve would also benefit from seeing a dietitian to talk about dietary advice in the short term and achieving better blood glucose control in the long term. A pharmacist could help Steve choose an insulin pump if needed, and a blood glucose monitor for home use. A personal trainer or Athletic Therapist could help Steve start a manageable exercise routine.

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Conversation based on: Type 1 Diabetes " Steve a 24-year-old man with frequent urination "

Type 1 Diabetes " Steve a 24-year-old man with frequent urination "

  • Chantal Sayers
    Chantal Sayers Vancouver, BC 11 January 2024
    Metabolic syndrome is the combination of high blood pressure, high blood sugar, too much fat around the waist, low HDL (“good”) cholesterol, and high triglycerides. Metabolic syndrome increases your risk for heart disease, diabetes, and stroke.
    Reply to: Type 1 Diabetes " Steve a 24-year-old man with frequent urination "
  • Mr. Jackson Sayers BSc.,
    Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 02 May 2022
    Having a hypoglycemic event has not been shown to affect the way a patient subsequently manages their diabetes
    Reply to: Type 1 Diabetes " Steve a 24-year-old man with frequent urination "
    • Mr. Jackson Sayers BSc.,
      Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 02 May 2022
      Preventing hypoglycemia can be achieved through regular counselling, keeping an accurate log of blood sugars, proper dosing of insulin and most importantly, choosing the right insulin for each patient.
  • Mr. Jackson Sayers BSc.,
    Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 02 May 2022
    Hypoglycemia is the most common side effect of insulin treatment.
    Reply to: Type 1 Diabetes " Steve a 24-year-old man with frequent urination "
    • Mr. Jackson Sayers BSc.,
      Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 02 May 2022
      If patients experience any symptoms of hypoglycemia, they should see their health care practitioner a soon as possible for a review.
    • Mr. Jackson Sayers BSc.,
      Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 02 May 2022
      Many patients taking insulin are unaware that they are experiencing the symptoms of hypoglycemia.
    • Mr. Jackson Sayers BSc.,
      Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 02 May 2022
      Hypoglycemia is very common in diabetic patients taking insulin and can effect up to 87% of type 1 and 43% of type 2 diabetic patients. That’s nearly all of type 1 and half of type 2 diabetics.
  • Dr. Richard Bebb MD, ABIM, FRCPC
    Dr. Richard Bebb MD, ABIM, FRCPC Endocrinologist, Victoria, BC 07 December 2019
    Chat Type 1 Diabetes You An autoimmune disease that occurs when the pancreas no longer produces any insulin or produces very little insulin. Type 1 diabetes usually develops in childhood or adolescence and affects approximately 10% of people with diabetes. There is no cure. It is treated with lifelong insulin injections and careful attention to diet and physical activity. Formerly called insulin-dependent diabetes or juvenile diabetes.
    Reply to: Type 1 Diabetes " Steve a 24-year-old man with frequent urination "
    • Mr. Jackson Sayers BSc.,
      Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 14 April 2022
      Ask your physician about blood pressure and cholesterol monitoring, as diabetes increases your risk of developing cardiovascular problems.
  • K. Michael
    K. Michael 07 November 2015
    The case study mentions that Steve showed signs of muscle wasting. Why would diabetes cause muscle wasting ?
    Reply to: Type 1 Diabetes " Steve a 24-year-old man with frequent urination "
    • Mr. Jackson Sayers BSc.,
      Mr. Jackson Sayers BSc., Kinesiologist, Vancouver, BC 14 April 2022
      Visit your dentist regularly. People with diabetes are at a higher risk for gum disease related to poor blood sugar control.
    • AllieS
      AllieS 18 January 2016
      Type1 diabetics do not produce insulin, which results in the high blood glucose mentioned in the case study. Since glucose requires insulin in order to leave the blood stream and enter cells to be used as energy for the body, a Type1 diabetic uses alternate metabolic pathways to produce the energy they need for daily activities. Once such pathway breaks down muscle proteins, which would account for the muscle wasting Steve is experiencing.
    • K. Michael
      K. Michael 15 November 2015
      I knew that people with diabetes were at risk for circulatory issues with their hands and feet - the feet especially. But didn't know that muscle atrophy was also an issue.
    • Michelle Kaarto, BScK, CSEP CEP
      Michelle Kaarto, BScK, CSEP CEP 15 November 2015
      @K.Michael - people who have diabetes can have muscle wasting (atrophy) due to the muscles getting shortened and hardened, and also because diabetes can also affect the nerves that supply the extremities (hands and feet) which can contribute to muscle wasting too.
  • Healthymama
    Healthymama 06 May 2015
    What is the blood level that indicates diabetes?
    Reply to: Type 1 Diabetes " Steve a 24-year-old man with frequent urination "
    • K. Michael
      K. Michael 22 July 2015
      If your blood sugar shows either a drastic increase or decrease it could mean you have diabetes. At the very least you should see a doctor
    • Healthymama
      Healthymama 06 May 2015
      Blood sugar level, I mean.
  • Joy
    Joy 05 May 2015
    Steve would also benefit from an appointment with a Dietician.
    Reply to: Type 1 Diabetes " Steve a 24-year-old man with frequent urination "
    • K. Michael
      K. Michael 29 June 2015
      From what we have learned with my father that is not the case. It was almost 6 weeks after his diagnosis that he went to see a dietitian. It resulted in 2 visits to the ER with high sugar levels. I'm not sure if his case is the norm but would hope that it isn't.
    • Healthymama
      Healthymama 06 May 2015
      All newly diagnosed diabetic patients should be automatically sent to a nutritionist or dietician.
  • ShirleyG
    ShirleyG 27 April 2015
    As this diagnosis was made "later in life", could it have been present for some time ? What are the risks of Type 1 Diabetes going undiagnosed ?
    Reply to: Type 1 Diabetes " Steve a 24-year-old man with frequent urination "
    • K. Michael
      K. Michael 11 August 2015
      You can develop diabetes at any stage in life. It's not just found in youth
    • Healthymama
      Healthymama 06 May 2015
      Did he suspect he had diabetes?
  • Marla Bondar
    Marla Bondar 26 April 2015
    How would a young man in the prime of his life (24) only recently develop/or be diagnosed with Type 1 Diabetes? I thought this was something generally discovered in early childhood. Are there early risk factors parents can look for to prevent development of diabetes in their kids when they become adults?
    Reply to: Type 1 Diabetes " Steve a 24-year-old man with frequent urination "
    • Healthymama
      Healthymama 06 May 2015
      Can someone be diagnosed with diabetes at any time?
    • K. Michael
      K. Michael 30 April 2015
      Type 1 Diabetes just means that you need insulin to control it. I think that most people assume childhood diabetes and type 1 are the same because kids only ever get diagnosed with type 1
  • Joy
    Joy 24 April 2015
    What is the correlation between drinking the sugar-filled drinks lately and Steve's Type 1 Diabetes diagnosis? Does the disease make him crave sugar? Did the sugar cause the Diabetes?
    Reply to: Type 1 Diabetes " Steve a 24-year-old man with frequent urination "
    • Healthymama
      Healthymama 06 May 2015
      Type 1 is not caused by any type of sugar so it must be a craving thing I would think.
    • K. Michael
      K. Michael 30 April 2015
      I would imagine that, just like anything else, the increase of sugar in our diets makes it harder for our bodies to metabolize it properly. Diabetes is more than just sugar though - it's all of the components that make up the food and how our bodies process it
    • Marla Bondar
      Marla Bondar 26 April 2015
      Good question, Joy. I didn't know that drinking sugar-y drinks could be related to diabetes.

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