57 year old male
CASE: A 57 year old male patient who is a resident of nalgonda and farmer by occupation (lemon field)came to the casualty with altered sensorium since 1 day and Generalised weakness with uncontrolled sugars since 2 days History of presenting illness: Patient was apparently asymptomatic 1 year back . In Feb 2022 he started to talk irrelevantly and unable to recognize his family members so they went to a local Rmp who informed the patient attenders that patient is having high sugars and got admitted here to kamineni and diagnosed him with ?DKA HHS. He got few high bp recordings at that time. He also got diagnosed with ckd and having chronic pancreatitis. He had 3 days of hospital stay and and was on HAI (10U(initially 8U)-----X-----12U). Since then he was coming to regular check up every 3 months. He was alright since then. But the patient thought his sugars were in control so he stopped taking insulin since 2 days ( last dose was Monday morning 8am). on 25-7-2023 he again started to