33year old male with uncontrolled sugars
33year old male
diabetic since 7years used OHAs for 6years
and was started on inj.mixtard insulin as his sugars were uncontrolled on OHAs
pt is now on Inj.Human mixtard 20-15
Day before yesterday night pt had alcohol binge and did not eat ,so he did not take his insulin dosage following which
since yesterday mrng pt is having vomitings,3-4episodes yesterday,food as content
associated with generalised weakness ,giddiness since yesterday.so he did not take his insulin yesterday also
Since yesterday 3pm no futher episodes of vomitings but he is still feeling weak so they had brought him to casualty
No h/o fever,loose stools,pain abdomen
N/o cold, cough,shortness of breath
k/c/ o DM II since 7years on Mixtard insulin
Not a klc/O HTN,CVA,CAD
Occasional alcoholic (take alcohol during festivals) 10years
Occasional smoker since 1month
O/E Pt C/C
BP 110/60
PR 120/min, regular
GRBS 417mg/dl
Spo2 98% at RA
CVs s1s2+,No mumurs
RS BAE +,NVBS
Diagnosis: Uncontrolled sugars
Treatment
IVF NS @100ml/Hr
InJ PAN 40mg IV stat
inj Zofer 4mg Iv stat
Inj HAI according to Grbs
7am-10am-2pm -4pm -8pm-10pm-2am
BP /PR monitoring
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