History A 16-year-old girl was found unconscious in her room and has been brought to hospital. She was diagnosed with type 1 diabetes mellitus three years earlier, and currently takes NovoMix 30, 8 units twice daily. Her glycated haemoglobin (HbA1c) was checked last month and was 6.1% (normal range 4–5.9), indicating an average blood glucose level of 7.0 mmol/L over the past three months. 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 as much insulin as normal as she had been eating and drinking less. Examination Her mucous membranes are dry.
Her abdomen is soft but tender throughout. She vomits several times during the examination. She appears short of breath and is gasping. Her blood sugar, checked by the paramedics, is 24 mmol/L. Observations Temperature 36.8°C, heart rate 110/min, blood…
