Hypoglycemic coma-(e) this patient has experienced hypoglycemic coma. he does not have detectable c peptide, which indicates that
there is no endogenous insulin production, as would be expected in type 1 diabetes. the high insulin level is the result of
the patients use of exogenous insulin to treat diabetes. because he has not eaten enough to maintain glucose at an
adequate level, he has developed hypoglycemia. the lack of food intake has led to the ketosis. acute myocardial
infarction is a complication that generally occurs later in the course of diabetes when more atherosclerosis has developed.
the patient has no obvious source of sepsis. insulin is not injected into the bloodstream, and the injections are almost
never complicated by infection. hepatic failure is not a typical complication of diabetes mellitus. hyperosmolar coma can
complicate type 2 diabetes mellitus. the ketosis in this case results from decreased food intake; ketoacidosis would be
accompanied by hyperglycemia.
bp7 652bp8 776778pbd7 1191pbd8 1133
