33year old male with uncontrolled sugars

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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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