Division of Emergency Medicine, Department of Medicine, London Health Sciences Centre, London, ON.
Schulich School of Medicine and Dentistry, Western University, London, ON.
CJEM. 2020 Jan;22(1):19-22. doi: 10.1017/cem.2019.428.
A 21-year-old male with known type 1 diabetes mellitus presented to the emergency department (ED) with two days of vomiting, polyuria, and polydipsia after several days of viral upper respiratory tract infection symptoms. Since his symptom onset, his home capillary blood glucose readings have been higher than usual. On the day of presentation, his glucometer read "high," and he could not tolerate oral fluids. On examination, his pulse was 110 beats/minute, and his respiratory rate was 24 breaths/minute. He was afebrile, and the remaining vital signs were normal. Other than dry mucous membranes, his cardiopulmonary, abdominal, and neurologic exams were unremarkable. Venous blood gas demonstrated a pH of 7.25 mm Hg, pCO2 of 31 mm Hg, HCO3 of 13 mm Hg, anion gap of 18 mmol/L, and laboratory blood glucose of 40 mmol/L, as well as serum ketones measuring "large."
一位 21 岁男性，患有 1 型糖尿病，在上呼吸道病毒感染症状出现几天后，出现两天呕吐、多尿和多饮。自症状出现以来，他的家庭毛细血管血糖读数一直高于正常水平。就诊当天，他的血糖仪显示“高”，无法耐受口服液体。检查时，他的脉搏为 110 次/分钟，呼吸频率为 24 次/分钟。他无发热，其余生命体征正常。除了口腔干燥外，心肺、腹部和神经系统检查均无异常。静脉血气显示 pH 值为 7.25mmHg，pCO2 为 31mmHg，HCO3 为 13mmol/L，阴离子间隙为 18mmol/L，实验室血糖为 40mmol/L，血清酮体测量值为“大”。
