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New-onset type 1 diabetes — ABFM Board MCQ

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ModerateEndocrine/MetabolicNew-onset type 1 diabetesABFM Board

A 13-year-old girl has fatigue, weight loss, polyuria, and polydipsia. Random glucose is 356 mg/dL and urine has large ketones, but she is alert and not vomiting. Which of the following is the most appropriate next step?

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Correct answer: D — Urgent evaluation for new-onset type 1 diabetes

New hyperglycemia with ketonuria and classic symptoms in an adolescent suggests type 1 diabetes and risk of diabetic ketoacidosis. Urgent same-day evaluation is required.

Reference: ADA Standards of Care in Diabetes, Children and Adolescents, 2026