An 18-year-old male high school student who

An 18-year-old male high school student who had a 4-year history of a diabetes mellitus was brought to the emergency department because of excessive drowsiness, vomiting, and diarrhea. His diabetes had been well controlled with 40 units of NPH insulin daily until several days ago when he developed excessive thirst and polyuria. For the past 3 days, he 3 has also had headaches, myalgia, and a low-grade fever. Diarrhea and vomiting began 1 day ago. QUESTION: 1. What is the probable diagnosis of this patient based on the data presented? 2. What laboratory test(s) should be performed to follow this patient and aid in adjusting insulin levels? 3. Why are the urine ketones positive? 4. What methods are used to quantitate urine ketones? Which ketone(s) do they detect?

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