G. K. a 46-year old African-American female is admitted to the hospital because of “feeling weak”, “being thirsty a lot”, and having frequent urination. On assessment, the physician notes G.K. having fruity breath odor, skin is warm and dry, slightly drowsy, and with deep and rapid respiratory effort. She states some numbness and tingling of fingers and toes; a dime-size reddened area on the lateral aspect of the right toe is also noted.
Past medical history reveals that G.K. was diagnosed with Type 2 diabetes a year ago. She’s been taking glipizide 5 mg every morning before breakfast. Her father had a history of Type 2 diabetes and died of acute myocardial infarction four months ago. A week prior to admission to the hospital, she had some “flu-like” symptoms that resolved with self-medication of Tylenol extra strength, orange juice, and bedrest.
Laboratory results reveal the following:
Serum glucose: 650 mg/dl
Serum K+: 6.2 mEq/L
Arterial blood gas: pH 7.25; PaCO2 30 mm Hg; HCO3 14 mEq/L
The physician’s admitting diagnosis: Type 2 diabetes melitus, probable diabetic ketoacidosis.
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