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Medicine General 2e8604a3

An obese patient presented in casualty in an unconscious state. His blood sugar measured 400 mg%, urine tested positive for sugar and ketones; drug most useful in management is:

A
Glibenclamide
B
Troglitazone
C
Insulin
D
Chlorpropamide
High-Yield Explanation
Answer is C (Insulin) : 'Diabetic ketoacidosis cannot be reveed without insulin' - Harrison The patient in the above question is a definite case of diabetic Ketoacidosis, as suggested by increased blood sugar (Diabetes) and presence of sugar & ketones in urine (ketoacidosis) in an obese (type I) diabetic. Diabetic ketoacidosis cannot be reveed without insulin Remember: Apa from diabetes the only other common ketoacidotic state is alcoholic ketoacidosis. Alcoholic ketoacidosis is invariably associated with hypoglycemia. A plasma glucose estimation usually is required to delineate such patients. Most patients have a plasma glucose, levels of less than 150 mg/dl. Hyperglycemia may occur but is usually mild, & rarely if ever exceeds 300 mg/dl. It is impoant to know this distinction as, in contrast to diabetic acidosis this syndrome is rapidly reversed by the intravenous administration of glucose.

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