This is an insulitis of an islet of Langerhans in a patient who will eventually develop type I diabetes mellitus. The presence of the lymphocytic infiltrates in this edematous islet suggests an autoimmune mechanism for this process. The destruction of the islets leads to an absolute lack of insulin that characterizes type I diabetes mellitus.

Without circulating insuling, blood glucose rises and the energy source for fat and muscle becomes lipids, with resultant usage of fatty acids and generation of ketoacids. The complication of ketoacidosis is indicated by the urinalysis results below.



Macroscopic Urinalysis:

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Leukocyte esterase
Nitrite
pH
Protein
Blood
Specific gravity
Ketones
Glucose
Bilirubin
CharacteristicResult
ColorYellow
AppearanceClear
Leukocyte EsteraseNeg
NitriteNeg
pH5.5
ProteinNeg
BloodNeg
Specific Gravity1.025
Ketones4+
Glucose4+
BilirubinNeg

Microscopic Urinalysis:

CharacteristicResult
WBC/hpf None
RBC/hpf None
Casts None
Other None