Which symptoms are typical at presentation of type 1 diabetes mellitus?

• A. Polyuria, polydipsia, weight loss, fatigue; may present with diabetic ketoacidosis
• B. Hypertension and edema
• C. Weight gain and constipation
• D. Jaundice and pruritus

Answer: (A)

Type 1 diabetes mellitus presents when there is not enough insulin, so glucose stays in the blood and the body uses fat and protein for energy. This leads to osmotic diuresis, causing frequent urination and dehydration, which triggers increased thirst. Since glucose isn’t getting into cells, weight loss and fatigue occur despite normal or increased appetite. If insulin deficiency is severe, ketone production rises, leading to diabetic ketoacidosis, a common presenting complication that can include dehydration, abdominal pain, nausea or vomiting, rapid breathing, and sometimes mental status changes. These features together most accurately reflect the typical presentation at diagnosis.

Hypertension and edema aren’t typical features of new-onset type 1 diabetes. Weight gain and constipation don’t fit the classic picture, nor do jaundice and pruritus, which point more toward liver or biliary conditions.