Case presentation A 37-year-old female presented with lethargy, nausea, vomiting, decreased oral intake, and cold-like symptoms. She had a history of poorly controlled type 2 diabetes mellitus, hyperlipidemia, hypertension, and gastroesophageal reflux disease (GERD). She had visited the emergency department three days earlier, and the following laboratory tests were performed.
After discharge, she continued to experience a sustained reduction in oral intake and was unable to take her medications. Laboratory findings from the previous ER visit WBC: 18.1 × 10³ cells/mm³ Blood glucose: 118 mg/dL Bicarbonate: 14 mmol/L Anion gap: 13 Ketonuria Vital signs during the current visit Blood pressure: 154/108 mm Hg Heart rate: 120 beats per minute Temperature: Afebrile Respiratory rate: 21 breaths per minute Oxygen saturation: 99% Physical Examination: Somnolent and appeared uncomfortable…
