MEDizzy - Two diabetic patients are seen by an endocrinologist, Dr.

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Endocrine System

Two diabetic patients are seen by an endocrinologist, Dr. Saket. The first patient is a 16-year-old boy Raju who 2 years previously had presented with polyuria and polydipsia. The second patient is a 65-year-old woman Antara whose diabetes was identified by the presence of hyperglycemia on a routine blood glucose screen 10 years previously. Compared to Antara, Raju is more likely to

ExplanationRaju probably has type 1 (juvenile onset) diabetes mellitus, while Antara probably has type 2 (maturity onset) diabetes mellitus. These two types of diabetes differ in many respects. Ketoacidosis is more likely to develop in type 1 diabetes. Type 1 diabetes has a strong association with HLA-DR3 and HLA-DR4 (option A), while type 2 does not have any strong HLA associations. Type 1 is usually apparently due to viral or immune destruction of beta cells, while type 2 is apparently usually due to increased resistance to insulin; consequently the 65-year-old, rather than the 16-year-old, is more likely to have relatively high endogenous levels of insulin (option D). Type 2 diabetes can often be controlled with oral hypoglycemic agents (option B), while type 1 diabetics generally require insulin. Note that some type 2 diabetics also may require insulin as the disease evolves.