Wednesday, January 18, 2023

20 year old male with uncontrolled sugars

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This is a case of 20 year old male came with cheif complaint of weight loss of nearly 7 kgs (73kgs to 67 kgs ) within 1 month,polydypsia since 6 months 

History of present illness:- 
Patient was apparently asymptomatic 1 month back then he noticed gradual loss of weight nearly 7 kgs ( unintensional - from 73 kgs to 67 kgs) in a span of 1 month.He had h/o polydypsia since 6 months(drinks 7 to 8 liters of water per day).H/0 polyuria,delayed wound healing present .Tingling sensation of fingers of lower limbs.No h/o numbness or loss of sensation.No h/o fatigue,giddiness.No h/o fever,burning micturition.

Past history:-
K/c/o type 1 DM since 2 years( on inj.HAI 40U inj.NPH 40 U ).H/o fulminant hepatic failure a year back and h/o CVA 1 yr back .Not a known case of Htn,thyroid,TB,epilepsy,asthma,CAD.

Personal history:-
Mixed diet
Sleep and apettite normal
Bowel and bladder regular
No addictions
No known allergies

Family history:-
Not significant 

GENERAL EXAMINATION:

-  Patient was examined after taking his consent 
-  Patient is conscious , coherent , cooperative , well oriented to time , place and person 
-  He is moderately built and nourished 
-  No signs of pallor , icterus , cyanosis , clubbing , oedema , lymphadenopathy 

His vitals: 

Temperature : afebrile
BP : 120/80 mm HG 
Pulse rate : 78 / min 
Resp.rate : 16 cpm
Grbs:160 mg/dl 

Systemic Examination:

CVS- S1 S2 heard,no murmurs present.

RS - bilateral Air entry present
Normal vesicular breath sounds heard

Per Abdomen : soft , non tender 

CNS :no focal neurologocal deficits 

Investigations
Plbs: 403 mg/dl
Fbs:- 222mg/dl
Sr.creatinine: 0.8 mg/dl
HbA1c: 7.5 %
Uncontrolled type 1 Diabetes mellitus