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16th September 2024
A 24-year-old male with T1DM initially presented to the emergency department with confusion and seizures
A 24-year-old male with T1DM initially presented to the emergency department with confusion and seizures. He was found to be hyperglycaemic, ketotic, and acidotic. He weighs 70 kg and has been on a fixed-rate insulin infusion of 7 units per hour for the past 8 hours, during which he has received 5L of fluid. Although he is feeling better, he is still not eating or drinking. His usual regimen includes twice daily long acting detemir with actrapid boluses, but these have been temporarily suspended. The doctor performs a venous blood gas (VBG) and measures his ketones, obtaining the following results:
| pH | 7.33 (7.35-7.45) |
| Lactate | 2.1 mmol/l (0.5-2.2) |
| Glucose | 20 mmol/l (4.0-5.4) |
| Ketones | 0.4 mmol/l (<0.6) |
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