A 21-year-old noncompliant female with a history of type I (insulin-dependent) diabetes mellitus was found in a coma. Her blood glucose was high, as well as her urine glucose, urine ketones, and serum ketones. Her serum bicarbonate was < 12 mEq/L (normal = 23-29 mEq/L). Her respiration was exaggerated, and her breath had an acetone odor. Her blood pressure was 90/60, and her pulse weak and rapid (120 bpm).
What causes type I diabetes mellitus? What is the fundamental organ and cell type impacted? How is this different from type II diabetes?
Differentiate ketoacidosis from insulin shock. Is this person experiencing ketoacidosis or insulin shock? Explain your answer.
pH considerations
What is the acid-base status of this individual?
Explain why her serum bicarbonate is low. (2 points)
What is the cause of the hyperpnea (rapid deep breathing)? (2 points)
What would cause this female's hypotension as well as her tachycardia (HR > 100 bpm)?
What type of treatment does this person need?
6. It is not uncommon for a person with extreme hyperglycemia to experience nausea. This can, in turn, elicit the fight-or-flight response. Considering how the endocrine system responds in a fight-or-flight situation, hypothesize why this response may worsen a diabetic's situation.