In type 1 diabetes, the β cells of the islets of Langerhans are destroyed by an autoimmune response, so little or no insulin is produced. A patient with untreated type 1 diabetes has a fasting blood glucose concentration of 11.8 mmol/dm3 (normal fasting range is approximately 4.0-5.9 mmol/dm3).
(a)Explain why a person with untreated type 1 diabetes has a persistently high blood glucose concentration.(2)
(b)Calculate the percentage by which this patient's fasting blood glucose concentration (11.8 mmol/dm3) exceeds the upper limit of the normal fasting range (5.9 mmol/dm3).(2)
(c)When blood glucose concentration exceeds the kidney's reabsorption capacity (the renal threshold, approximately 10 mmol/dm3), glucose appears in the urine. Explain, in terms of the proximal convoluted tubule, why glucose is normally completely reabsorbed from the filtrate but appears in the urine of this patient.(3)
(d)Explain why untreated type 1 diabetes also causes excessive urine production (polyuria).(1)
(Total for Question 4 is 8 marks)