15th August 2023

A 27-year-old man, recently diagnosed with type 2 diabetes, is brought into the emergency department by his friend

A 27-year-old man, recently diagnosed with type 2 diabetes, is brought into the emergency department by his friend, who reports that he has been increasingly confused and drowsy. On examination, the patient is tachycardic, hypotensive, and has a reduced Glasgow Coma Scale (GCS). Arterial blood gas shows a pH of 7.28, bicarbonate 12 mmol/L, and blood glucose 35 mmol/L. Urine dipstick is positive for ketones.

Which of the following conditions is the patient most likely suffering from?