Sweet and Salty

Authors: Amy Jones, Hayley Mistri / Editors: Mark Winstanley / Reviewer: Kathryn Blackmore, Ciaran Mackle / Code: / Published: 14/11/2021

A 62-year-old lady presents with a 2 week history of feeling generally unwell. She has felt intermittently dizzy, nauseous and lethargic. She has a past medical history of type 2 diabetes mellitus, hypertension and CKD. Her GP has done some bloods one week previously, which had shown a deterioration in her renal function from baseline, and so they had stopped her Metformin.

She presents to the Emergency Department (ED) following a severe attack of nausea and dizziness followed by collapse at home. On arrival her observations are: HR 93 BP 106/78 sats 100% air RR 22.

A venous blood gas taken on arrival shows a pH of 7.30

Glucose unrecordably high. Ketones are 0.03

Na 156 HB 111 Glucose 67

K 4.8 WCC 7.34

Ur 11.4 PLT 99

Cr231 CRP <5

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