Question

Case Study about Carbohydrate -Related Medical Problem (Diabetes Mellitus)
Patient History: RX, a 6-year-old girl in previously good health, has noticed that, in the past
month, she is increasingly thirsty. She gets up several times a night to urinate, and finds herself
gulping down large amount of water. At the dinner table, she seems to be eating twice as much
as she used to, yet she has lost 4 kilograms in the past month. In the past three days, she has
become nauseated, vomiting on three occasions, prompting a visit to her pediatrician.
Laboratory Results:
 Fasting blood glucose level = 445 mg/dl
 blood pH level = 7.23
 Hb A1C = 9.5%
 C-Peptide Test = 0.4 ng/ml
 urine = tested positive for glucose and for acetone / acetoacetate/ beta hydroxybutyric
acid
Based on the given case, answer the following guide questions:
1. What is the relationship between Diabetes and Carbohydrates? How are carbohydrates
contributing to the patient’s diagnosis of high blood glucose level?
2. Compare and contrast the two main types of Carbohydrates. Which among the two types
can cause the biggest jump in your blood sugar and why?3. Diabetes is a metabolic disease that impacts the body’s production and/or utilization of
insulin. In Type 1 diabetes the body fails to produce insulin; whereas in Type 2 diabetes
the body produces insulin (and sometimes excessive amounts of it) but for a variety of
reasons the insulin does not function as it should. Now, give two reasons and explain why
insulin is beneficial especially for diabetic patients.
4. Explain why her blood-glucose level is elevated?
5. Why is her blood pH level decreased?
6. RX has a fruity odor to her breath. Explain why.
7. Explain why RX is urinating so frequently.
8. How is RX's condition like that of starvation? Address the role of glucagon in your
answer.
9. Based on your answer in no. 2, what foods will be highly recommended to the patient?
Explain.
10. Do you believe that you can adjust your diabetes drugs to ‘Cover’ whatever you eat?
Why?

Answer 1

In the given case, RX is a patient with mild diabetic ketoacidosis whuch is evident from the laboratory findings.

1.High intake of carbohydrates through diet can account to diabetes as the basic unit of carbohydrate is glucose itself leading to increased blood glucose levels.

2.The two main types of carbohydrates are monosaccharides and polysaccharides. Among these two types, monosaccharides like glucose and fructose can lead to sudden increase in blood glucose whereas, polysaccharides like starch can lead to a prolonged and persistent increase not a sudden rise in blood glucose.

3.Insulin is a hormone which can help in reducing blood glucose level by inducing the cells to take up the available glucose and utilise for cellular needs.

4. In this patient, blood glucose level is elevated due to reduced insulin release.

5. Blood pH is usually decreased in diabetic ketoacidosis due to loss of bicarbonate buffer and reduced availability of bicarbonate ions.

6. Fruity odour in breath is due to ketoacidosis as is evident from presence of ketone bodies in urine.

7.In patients with diabetes, excess glucose in blood force kidneys to filter and absorb the excessive glucose making frequent urination.

8. Type 1 diabetes is very similar to stravation condition as even when the extracellular levels of glucose is high, its intracellular levels will be less. Mainly, non-glucose sources of energy like fatty acids and ketone bodies are used up.