A patient presents with blurred vision, extreme fatigue, numbness in hands, insatiable thirst, hunger, and polyuria with uOSMO 700 mOsm/kg and positive glucose in urine. What is the likely diagnosis?

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When blood glucose is very high, the kidneys can’t reabsorb all of it, so glucose spills into the urine. Water follows that glucose, leading to large urine volumes (polyuria) and dehydration, which triggers thirst (polydipsia). The combination of extreme thirst, frequent urination, and glucose in the urine is a classic sign of hyperglycemia from diabetes mellitus. Blurred vision occurs because high glucose levels change the lens, and numbness can appear with prolonged hyperglycemia (neuropathy). The urine osmolality being quite high indicates the urine is concentrated, which helps distinguish this from diabetes insipidus (where urine is very dilute and there’s no glucose in the urine). Taken together, this symptom pattern—polyuria, polydipsia, polyphagia with glycosuria and hyperglycemia—most strongly points to Type I diabetes, due to autoimmune destruction of pancreatic beta cells leading to insulin deficiency.