Can you make the diagnosis?

John has been feeling tired all of the time lately.  He has blamed his fatigue on having to get up multiple times during the night to urinate.  He feels thirsty during the day, and has been drinking large quantities of water and soda.  Sometimes, on his way to work, he is so thirsty he has to stop at a convenience store to get something to drink.  He also feels very hungry during the day, and feels like he has to snack frequently.

What is wrong with John?

  1. He has a urinary tract infection
  2. Thyroid problem
  3. He has a prostate problem
  4. New onset diabetes



If you picked 4. New onset diabetes, you are correct!

Diabetes is a disorder caused by high blood sugar (also called glucose).  It can cause symptoms such as frequent urination, increased thirst, and increased hunger.

If left untreated, diabetes can cause problems such as kidney disorders,  vision problems, and cardiovascular complications.

Type I Diabetes, also called “juvenile diabetes”, most often begins during childhood and is caused by the pancreas not producing enough insulin.

Type II Diabetes results from insulin resistance, and usually starts during adulthood.

Testing for diabetes includes checking the patient’s blood sugar and checking an A1C.  The A1C is a test that can diagnose diabetes.  For patients who have known diabetes, it also tells how well the diabetic patient is managing their condition.

A normal A1C is below 5.7 percent.  If it is between 5.7 to 6.4, the patient may have pre-diabetes, which can ultimately lead to diabetes.   An A1C that is 6.5 or greater shows that the patient has diabetes.


A urinary tract infection is a possibility, but would also typically be accompanied by burning with urination and a fever.  Thyroid problems can cause fatigue and may affect appetite, but would be unlikely to cause increased thirst.  Prostate problems can cause need for frequent urination due to incomplete emptying, but would be unlikely to cause increased thirst and hunger.



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