A 34-year-old woman with diabetes admitted to the emergency department in a stuporous state. Her skin is flushed and warm, her breath has a sweet odor, her pulse is rapid, and her breathing is rapid and deep. Her initial lab tests indicate a blood glucose level of 320 mg/dL, serum HCO3 of 12 mEq/dL, pCO2 of 38 mmHg, Na levels of 147 mEq/L, K levels of 4 mEq/L, and Cl levels of 110 mEq/L.