T1DM presenting with DKA — RACP Paediatrics MCQ

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EasyEndocrineT1DM presenting with DKARACP Paediatrics

An 8-year-old presents with polyuria, polydipsia, weight loss, and fatigue. Random blood glucose is 22 mmol/L. Ketones are 4.5 mmol/L. pH is 7.28. What is the most likely diagnosis?

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Correct answer: D — Type 1 diabetes mellitus

Polyuria, polydipsia, weight loss, and hyperglycaemia with ketonuria/ketonaemia in a child is type 1 diabetes mellitus until proven otherwise. This child has DKA (pH <7.30, ketones elevated). Immediate management as per DKA protocol is required. Do not confuse polyuria from osmotic diuresis (glucosuria) with diabetes insipidus.

Reference: RCH Melbourne – 2023 – DKA CPG; RACP Paediatric Curriculum – Endocrine