Keywords: Ketoacidosis, Tirzepatide, Renal failure, Diabetes, Weight loss
A 45-year-old female was brought into the Emergency Department by ambulance after being found unconscious at home by family. Upon obtaining collateral history from the family, it was evident that the patient had a recent episode of diarrhea and vomiting 10 days ago. Additionally, there were concerns of significant weight loss over the last 12 months.
PMH:
- Type 2 Diabetes Mellitus (T2DM)
- Cerebral infarction
- On Tirzepatide for weight loss
Observations:
- Oxygen saturation of 100% on room air
- Respiratory rate of 40 breaths per minute
- Blood pressure of 90/40, heart rate of 82 beats per second
- Glasgow Coma Scale (GCS) 6/15 (Eyes 4, Verbal 1, Motor 1)
- Temperature: 30 degrees Celsius
- Capillary blood glucose done at bedside: 4.7 mmol/l
On examination:
- Patient’s airway was patent
- Chest was clear to auscultation
- Abdomen was soft, non-tender
- Neurological examination revealed diffuse bilateral facial, upper, and lower limb muscular rigidity and bilateral nystagmus with fixed gaze.
