Interactive diabetes case 7: Management of diabetes in a 72-year-old patient with type 2 diabetes, GI bleeding, and multiple other medical problems – A3

ANSWER — Incorrect.

The patient is brought into the emergency department one week later because of nausea, confusion, and inability to walk. He is in shock with a profound anion-gap metabolic acidosis. The arterial pH is 6.91. The patient is admitted to the intensive care unit, intubated, and treated with volume replacement, pressors, and antibiotics. He expires 48 hours later. The diagnosis is metformin-induced lactic acidosis in a patient with chronic kidney disease and congestive heart failure.

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