14.5 Laboratory findings and clinical symptoms in acute type I diabetes
- Increased blood glucose. The normal concentration range is 5-9 mM; in acute diabetes, it can be many times higher.
- Acidic deviation of the blood pH. This is mainly due to the increased formation of ketone bodies, which are acids. This condition is called ketoacidosis.
- Increased blood fats (lipoproteins).
- Increased plasma and urine levels of urea, due to the accelerated protein breakdown in muscle.
- Decreased levels of insulin and of C-peptide.
In addition to these laboratory parameters, acute type I diabetes is characterized by these symptoms:
- Thirst, increased urine flow. Thirst, obviously, is due to the loss of fluid, and this in turn is due to the osmotic activity of glucose in the urine. The reason why diabetics loose glucose in the urine is discussed below.
- Acetone smell. As discussed in section 10.3.1, acetone forms as a byproduct of ketone bodies.
- Recent loss of weight. Both protein and fat are being degraded, and the loss of glucose in the urine can amount to a significant loss of calories.
- In severe cases, the patients may be unconscious (comatose). Two effects may contribute: The pH deviation (ketoacidosis), and blood plasma hyperosmolarity, a consequence of the high glucose concentration. The high osmotic activity of the blood and interstitial fluids drains water from the cells, which hampers cell function.
- Some patients report a recent flu-like infection, sometimes with chest pain or even myocarditis (inflammation of the heart muscle).