obsolete diabetes mellitus,insulin dependent type with hyperosmolarity, not stated as uncontrolled

Based on the search results, it appears that there are descriptions of a condition characterized by hyperosmolarity in individuals with insulin-dependent diabetes mellitus (IDDM), also known as Type 1 diabetes.

According to result [10], this condition was first described around 1880 by Won Frerichs and Dreschfeld, who described patients with diabetes mellitus with profound hyperglycemia and glycosuria without the classic Kussmaul breathing or acetone in the breath. This suggests that hyperosmolarity can occur in individuals with IDDM.

However, it's worth noting that this condition is not explicitly stated as being uncontrolled in the search results. In fact, result [13] mentions that occasional patients with insulin-resistant type 2 diabetes with hyperosmolar hyperglycemic state require larger insulin doses, suggesting that hyperosmolarity can occur even when diabetes is being managed with insulin.

Therefore, while there are descriptions of a condition characterized by hyperosmolarity in individuals with IDDM, it's not clear whether this condition is necessarily associated with uncontrolled diabetes.

Based on the search results, here are the signs and symptoms of hyperosmolar hyperglycemic state (HHS) associated with insulin-dependent type 1 diabetes mellitus:

• Early symptoms: Polydipsia (excessive thirst), polyphagia (increased hunger), polyuria (frequent urination), and blurred vision [5]
• Later complications: Vascular disease, which can lead to abdominal pain or tenderness, nausea and vomiting, lack of bowel sounds, and ileus in patients with uncontrolled diabetes [7]

Note that these symptoms are not necessarily indicative of uncontrolled diabetes, but rather a complication associated with insulin-dependent type 1 diabetes mellitus.

References: [5] Early symptoms related to hyperglycemia include polydipsia, polyphagia, polyuria, and blurred vision. [7] Abdominal pain or tenderness, nausea and vomiting, lack of bowel sounds and ileus in patients with uncontrolled diabetes may obscure intra-...

Based on the search results, it appears that there are diagnostic tests for diabetes mellitus, insulin-dependent type (IDDM) with hyperosmolarity. However, I couldn't find any specific information on obsolete diagnostic tests.

That being said, I can provide some general information on diagnostic tests for IDDM and hyperosmolar hyperglycemic state (HHS).

• Blood glucose level: A blood glucose level of 250 mg per dL (13.9 mmol per L) is considered a diagnostic criterion for diabetic ketoacidosis (DKA), which can be associated with HHS [2].
• Arterial pH and bicarbonate level: An arterial pH of 7.3 and a bicarbonate level of 15 mEq per L are also diagnostic criteria for DKA, which may be relevant to IDDM with hyperosmolarity [2].
• Fasting plasma glucose level: A fasting plasma glucose level >126 mg/dL (7.0 mmol/L) or a casual plasma glucose >200 mg/dL (11.1 mmol/L) meets the threshold for the diagnosis of diabetes, which may be relevant to IDDM and HHS [4].
• A1C level: The A1C level is also used as a diagnostic screening test for diabetes, including IDDM and HHS [7].

It's worth noting that these tests are not specific to obsolete diagnostic tests, but rather general diagnostic criteria for IDDM and HHS.

References: [2] - Diagnostic criteria for DKA include blood glucose level of 250 mg per dL (13.9 mmol per L), arterial pH of 7.3, bicarbonate level of 15 mEq per ... [4] - A fasting plasma glucose level >126 mg/dl (7.0 mmol/l) or a casual plasma glucose >200 mg/dl (11.1 mmol/l) meets the threshold for the diagnosis of diabetes. [7] - The diagnosis is based on measurement of A1C level, fasting or random blood glucose level, or oral glucose tolerance testing.

Please let me know if you would like me to clarify anything!

Based on the search results, it appears that there are limited information available on the specific treatment for insulin-dependent type 2 diabetes mellitus with hyperosmolarity.

However, I can provide some general information on the treatment of diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS), which may be relevant to your question.

• According to search result [7], a Fixed Rate Intravenous Insulin Infusion (FRIII) is recommended for the treatment of HHS, with a starting dose of 0.1 units/kg/h.
• Search result [9] suggests that IV insulin in dosages similar to those used in DKA can facilitate correction of hyperglycemia and hyperosmolarity in HHS.
• However, it's worth noting that search results [6] and [10] mention that following recovery from HHS, many patients may not require long-term insulin therapy and can be managed effectively with diet or oral agents.

It's also important to note that the treatment of DKA and HHS is similar, but the specific approach may vary depending on the individual patient's condition. A comprehensive clinical and biochemical evaluation is key to determining the best course of treatment for these conditions.

In terms of drug treatment specifically for insulin-dependent type 2 diabetes mellitus with hyperosmolarity, I couldn't find any direct information in the search results. However, it's possible that a more specific or detailed search may yield relevant information.

References: [7] Mustafa OG (2023) [cited by 30] [9] Levine SN (1989) [cited by 45] [10] Frerichs W and Dreschfeld (1880) [cited by unknown]

Based on the search results, it appears that there are several conditions that can present with hyperosmolarity in patients with diabetes mellitus.

• Diabetic ketoacidosis (DKA): This is a serious complication of diabetes that occurs when the body produces high levels of ketones due to a lack of insulin. DKA can cause severe dehydration and electrolyte imbalances, which can lead to hyperosmolarity ([7], [15]).
• Hyperglycemic hyperosmolar state (HHS): This is another complication of diabetes that occurs when there is an extremely high blood sugar level without the presence of ketoacidosis. HHS can also cause severe dehydration and electrolyte imbalances, leading to hyperosmolarity ([4], [10]).
• Diabetic hyperosmolar coma: This is a rare but life-threatening condition that occurs when patients with diabetes develop severe dehydration and very high blood glucose levels (hyperglycaemia). The exact mechanism of this condition is not fully understood, but it is thought to be related to the body's inability to regulate fluid balance ([9], [10]).

It's worth noting that these conditions can present similarly, making differential diagnosis challenging. However, a careful evaluation of the patient's clinical presentation, laboratory results, and medical history can help differentiate between these conditions.

In terms of differential diagnosis, it would be essential to rule out other causes of hyperosmolarity such as:

• Renal failure: This can cause an increase in serum osmolality due to the accumulation of urea and other waste products.
• Liver disease: Certain liver diseases, such as cirrhosis, can lead to an increase in serum osmolality due to the accumulation of toxins.
• Sodium retention: Conditions that cause sodium retention, such as heart failure or nephrotic syndrome, can also lead to hyperosmolarity.

A thorough evaluation and consideration of these potential causes would be necessary to accurately diagnose the underlying condition.