A 21 year old noncomplaint male with a history of type I (insulin-dependent) diabetes mellitus was found in a coma. His blood glucose was high, as well as his urine glucose, urine ketones, and serum ketones. His serum bicarbonate was <12 mEq/L. His respiration was exaggerated and his breath had an acetone odor. His blood pressure was 90/60 and his pulse weak and rapid (120).
Diabetes - 3 Answers
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low bicarb = acidosis
, he has got a metabolic acidosis, dehidration and coma hiperosmolar
This is diabetic ketoacidosis. His ketones rose significantly because of a lack of insulin. I think the bicarb is low because the body wastes it (from the kidneys) because in ketoacidosis, the body produces more urine. It's kussmaul respirations, the body is trying to rid carbon dioxide and the ketones produce a fruity smell on the breath. it's a anion gap metabolic acidosis.
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