Which laboratory test is the best predictor of blood glucose control over the previous few months?

Choice A reason: Polydipsia refers to excessive thirst, polyuria refers to frequent urination, polyphagia refers to increased hunger, weight loss often occurs despite an increased appetite, and fatigue is a common symptom due to the body's inability to properly use glucose for energy. These symptoms are classic early signs of type 1 diabetes and occur because the body cannot produce enough insulin to regulate blood sugar levels.

Choice B reason: While weakness, vomiting, hypotension, and mental confusion can be symptoms associated with diabetic ketoacidosis (a serious complication of diabetes), they are not typically the earliest signs of type 1 diabetes. These symptoms may develop later if diabetes is not managed properly.

Choice C reason: Recurrent infections, visual changes, and paresthesia can occur in individuals with diabetes, but they are more common in long-standing diabetes and are not the earliest signs. These symptoms result from chronic high blood sugar levels affecting various body systems.

Choice D reason: Vomiting, abdominal pain, sweet, fruity breath, dehydration, and Kussmaul breathing are symptoms of diabetic ketoacidosis (DKA), a severe and life-threatening complication of diabetes. While these symptoms can occur in individuals with type 1 diabetes, they are not the initial signs but rather indicators of an advanced and poorly controlled condition.

Choice A reason: Identification of a significant amount of protein in the urine (proteinuria) is an abnormal finding that can indicate underlying kidney problems. Proteinuria can be a sign of kidney disease, as the kidneys normally prevent large amounts of protein from entering the urine. When protein is detected in the urine, it suggests that the kidneys' filtering mechanism may be damaged. This condition requires further clinical assessment to determine the underlying cause and appropriate treatment.

Choice B reason: It is incorrect to assume that proteinuria will resolve itself without intervention. While some causes of proteinuria, such as temporary increases due to fever or intense physical activity, may be benign and resolve on their own, persistent or significant proteinuria is often indicative of a more serious underlying condition. Ignoring the presence of protein in the urine without further investigation could lead to worsening kidney function or other complications.

Choice C reason: While staying hydrated by drinking 1-2 liters of water per day is generally good advice for overall health, it is not a specific solution for proteinuria. Proper hydration can help maintain kidney function, but it does not address the underlying cause of protein in the urine. Clinical assessment and targeted treatment are necessary to manage proteinuria effectively.

Choice D reason: Dismissing proteinuria as nothing to be worried about is not appropriate. Significant protein in the urine is a clinical finding that warrants further investigation. It could be a sign of kidney disease, diabetes, hypertension, or other health issues that require medical attention. Early diagnosis and management are crucial to prevent potential complications and preserve kidney health.