A 19-year-old with type 1 diabetes has vomiting, deep sighing breathing, fruity breath and a blood glucose of 27 mmol/L. What is the most likely diagnosis?
Answer and explanation
Correct answer: C. Diabetic ketoacidosis
- Step 1: The picture of hyperglycaemia with ketones and metabolic acidosis fits Diabetic ketoacidosis.
Answer
Diabetic ketoacidosis.
Why not the others: 'Hyperosmolar hyperglycaemic state': it occurs in type 2 diabetes with very high glucose but little ketosis. 'Lactic acidosis': lactic acidosis has a raised lactate without large ketone levels. 'Alcoholic ketoacidosis': it follows heavy drinking and usually has a normal or low glucose.
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