1. The patient was brought to the emergency room after being unable to get out of bed and vomiting. Tests were performed to determine if the patient had diabetes or was experiencing side effects from an unknown powder found by his bed. 2. Urinalysis showed high levels of glucose and ketones, indicating the patient's body was not breaking down glucose efficiently. A glucose oxidase assay found extremely high glucose levels in the patient's blood. 3. Thin layer chromatography identified the powder as paracetamol. While the patient was showing signs of paracetamol overdose, diabetes was considered a more likely diagnosis given the patient's young age and symptoms. More tests were still needed to confirm type 1 diabetes

1. 1. Introduction
Background information on Patient A
Mr A is a 9 year old male who has been recently
tired and drowsy. His respiration is deep and
blood pressure is lower than it should be. There
has been an increase on the amount of water
than he's drinking and a higher amount of urine is
being passed. There was a unknown drug in a
powder form next to the patients bed.
The patient has been brought into A&E after
being unable to get out of bed and vomiting. The
powder has been brought into A&E for testing to
identify the drug and to see if it is causing any of
the symptoms.
Test are needed to be done to see if the patient
has a condition that needs treatment.
The patient is supplying symptoms for diabetes.
These symptoms include tiredness, being very
thirsty and more urine is being passed. (4) The
patient is young so it is more likely to be type 1
as it is more likely to appear in childhood (2).
Diabetes occurs when the beta cells in the islets
of Langerhans are unable to produce or produce
very little insulin. (4) Insulin is needed to
decrease the glucose levels.
3.3 Glucose oxidase assay3. Results and Discussion
3.1 Urinalysis dipstick screening
Figure 1: Results of dipstick screening.
The results that are shown in figure 1 allowed
to easily see any abnormalities. This indicated
what further test should be done.
The results showed a high presence of
glucose and ketones. A high glucose
concentration in the urine means that glucose
isn’t being broken down efficiently. The
normal glucose level should be between 0-
0.8mmol/L (4).
Figure 4: Standard curve of glucose
concentration.
For the patient’s sample, they got an absorbance
of 2.993 at 570nm.
The concentration was found using the equation
y=0.1225x. This found that the concentration of
glucose in the patients sample was 24.4mmol/L.
The normal glucose concentration should be
around (3.5-5.5 mmol/L) (1). This is extremely
higher than it should be indicating that it isn’t
being broken down. The high glucose level can
lead to the body becoming damaged and cause
other serious problems.
Department of Biosciences
Author: Georgia Cooper
Department of Biosciences and Chemistry, Faculty of Health and Wellbeing, Sheffield Hallam University, Sheffield S1 1WB.
Investigation to potentially diagnose a unknown condition or
side effects from a unknown drug using bioanalytical
techniques

2. Conclusions
From the tests and symptoms that patient is
expressing, it is revealing the patient may
have type 1 diabetes.
The urinalysis dipstick screening showed that
there was a high amount of glucose and
ketones in the urine. Testing for ketones in
urine is more common with people with type 1
diabetes (5). The higher amount of ketone
means less insulin is being produced by beta
cells in the pancreas.
The glucose oxidase assay showed that the
patient had a high amount of glucose present.
The drug was concluded to be paracetamol,
however it is unknown if or how much the
patient has taken. The patient is showing
signs of an overdose including vomiting (3)
but it is less likely.
More test will be needed to ensure that the
patient does have type 1 diabetes because if
treatment if given without having the condition
it will cause serious harm to the patients body.
References
1.. Guemes. M., Rahman. S. A., Hussain. K., (2016).
What is a normal blood glucose. 101, (6), 569- 574.
2. Nhsinfrom., (2019). Type 1 diabetes. Retrieved
from https://www.nhsinform.scot/illnesses-and-
conditions/diabetes/type-1-diabetes
3. NHS.co.uk. (). Paracetamol. Retrieved from
https://www.nhs.uk/conditions/paracetamol/
4. Pointer. K., 2017. Everything You Need to Know
About Glucose. Healthline.
5. Stoppler. M. C., (2018). Diabetes urine test.
Medicine Net.
Acknowledgements
Thanks to Maisie Cottrell for the help gaining the
data.
Thanks to SHU for the use of resources.
3.2 Thin layer chromatography
Figure 2: TLC plate under UV light. A= aspirin,
P= paracetamol, I= ibuprofen and U1=
unknown sample
Figure 3: The results from TLC, showing the
Rf values.
It was identified that the unknown powder was
paracetamol as there Rf value were very
similar which is shown in figure 3. The TLC
plate shown in figure 2 clearly shows that they
travelled a similar distance meaning they
contain the same components.
Due to glucose not being broken down fatty
acids from fat stored will be broken down instead
producing a high amount of ketones which is the
waste product (4).
Compounds Rf value
Aspirin 0.5200
Paracetamol 0.2269
Ibuprofen 0.6530
Unknown powder 0.2400