Patient Profile:
A 45-year-old male patient presented to the emergency department at 2 AM with vomiting and abdominal pain. He had a 2-week history of polyuria and polydipsia, accompanied by a 9 kg weight loss and blurred vision. His medical history was unremarkable, except for being treated for hypertension with amlodipine 10 mg daily, which provided good control. (His blood pressure on admission was 135/80.)
Results of hospital laboratory studies revealed that the patient's initial blood glucose level was 350 mg/dL. The patient reported no family history of diabetes. His father died at age 35 of renal failure.
1) What is the primary problem and what is its underlying cause or pathophysiology?