Specimen Name Result Units Range
Plasma Sodium 144 mmol/L (135-145)
Potassium 5.0 mmol/L (3.5-5.5)
Chloride 97 mmol/L (100-109)
Bicarbonate 5 mmol/L (22-32)
Anion Gap 47 mmol/L (7-17)
Glucose 70 mmol/L (3.8-5.5)
Urea 26 mmol/L (2.7-7.2)
Creatinine 353 μmol/L (60-110)
Urea/Creat Ratio 73 (35-80)
Albumin 32 g/L (34-48)
Total Bilirubin 2 μmol/L (6-24)
GGT 203 U/L (< 60)
ALP 136 U/L (30-110)
ALT 152 U/L (< 55)
CK 223 U/L (< 200)

35yo male - unwell for 4-5 days. BIBA
Diabetic Ketoacidosis
  • hyperglycaemia : ∴ diabetic disorder
  • corrected [Na+] ≈ 164 mmol/L, ∴ major H2O losses
  • metabolic acidosis : ↑↑ AG, ∴ DKA ± lactate
  • 'hyperkalaemic', however
    • ↓pH≈0.1 → ↑K+≈0.5 mmol/L (pH < 7.0, ∴ likely K+-deficit)

However:

  • BGL elevation higher than usual for DKA → ?? Rx in ambulance
  • Anion gap : ↑AG >> HCO3- fall → ketoacids plus sig. pre-renal AKI
  • AKI is marked ∝ ?protracted illness leading into DKA
  • LFTs : moderate hepatic impairment ∝ ?hypoperfusion or concurrent sepsis