18th February 2025

A 72-year-old gentleman is seen by his GP for a routine diabetes review. His current treatment regime for his myeloma includes cyclophosphamide

A 72-year-old gentleman is seen by his GP for a routine diabetes review. His current treatment regime for his myeloma includes cyclophosphamide. Routine bloods reveal HbA1c 45 mmol/mol, random glucose 5.0 mmol/L, serum creatinine of 160 µmol/L (45-104 μmol/L). He reports feeling more thirsty than usual, however is passing urine well. He last opened his bowels 6 days ago, and he noticed his stools were hard and difficult to pass. On questioning, his wife reveals that he has appeared slightly more confused than usual.

What is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.