An 18-year-old male high school

An 18-year-old male high school
student who had a 4-year history of
diabetes mellitus was brought to the
emergency department because of
excessive drowsiness, vomiting, and
diarrhea. His diabetes had been well
controlled with 40 units of NPH
insulin daily until several days ago
when he developed excessive thirst
and polyuria. For the past 3 days, he
has also had headaches, myalgia,
and a low-grade fever. Diarrhea and
vomiting began 1 day ago.

QUESTION

1. What is the probable diagnosis of
this patient based on the data
presented?
2. What laboratory test(s) should be
performed to follow this patient and
aid in adjusting insulin levels?
3. Why are the urine ketones
positive?
4. What methods are used to
quantitate urine ketones? Which
ketones) do they detect?

Complete Answer:

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