A 16-year-old girl was found unconscious in her room and brought to the hospital. Medical history Type 1 diabetes mellitus, currently uses NovoMix 30, 8 units twice daily. HbA1c was checked last month and was found to be 6.1%. (Normal range 4-5.9) She has been suffering from a sore throat and influenza-like symptoms over the preceding days. Her parents say that she has not given herself the normal amount of insulin as she had been eating and drinking less. Examination Her mucous membranes are dry.
Her abdomen is soft but tender throughout. She vomited several times during the examination. She appears short of breath and is gasping. Her blood sugar, checked by the paramedics, is 24 mmol/L. Temperature : 36.8°C HR : 110/min BP : 90/50 mmHg RR : 32/min S aO 2 : 99% on room air Urine dip : Glucose : 4+ Ketones : 3+ Arterial blood gas on room air : pH : 7.12 P O 2 : 12.8 kPa P CO 2 : 2.8…
