A 39-year-old man comes to the office because of a 6-week history of mild fatigue and increased thirst and urination. During this time, he also has had a 6.8-kg (15-lb) weight loss despite no change in appetite. He is otherwise asymptomatic. He has no history of serious illness and takes no medications. He is 180 cm (5 ft 11 in) tall and weighs 61 kg (135 lb); BMI is 19 kg/m2. Temperature is 37.0°C (98.6°F), pulse is 80/min, respirations are 18/min, and blood pressure is 118/70 mm Hg. Examination shows no abnormalities. Results of laboratory studies are shown:
Serum
Na+ 135 mEq/L
K+ 4.2 mEq/L
Cl− 100 mEq/L
Urea nitrogen 25 mg/dL
Glucose 578 mg/dL

Blood
Hemoglobin A1c 10.7%

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