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Type 1 diabetes presentation — USMLE Step 3 MCQ

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EasyPediatrics (well-child, chronic management)Type 1 diabetes presentationUSMLE Step 3

A 9-year-old girl has 3 weeks of polyuria, polydipsia, weight loss, and fatigue. Glucose is 318 mg/dL, bicarbonate is 23 mEq/L, and urine ketones are trace. She is alert and hydrated. Which of the following is the most likely diagnosis?

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Correct answer: D — New-onset type 1 diabetes mellitus

Polyuria, polydipsia, weight loss, and marked hyperglycemia in a child indicate new-onset diabetes, commonly type 1.

Reference: ADA Standards of Care in Diabetes—2026