- Kyle has been diagnosed with Diabetes Mellitus type I when he was 12 years old. Today, Kyle is a 23 year old drummer in a rock band. He partied hard last night, and today he missed the band rehearsal. So his bandmates came to his apartment to check up on him and found Kyle unresponsive in bed. There was a strong smell of acetone in the room. They called an ambulance and Kyle was transported to a hospital. Upon assessment, Kyle’s glucose was found to be in the high 500’s, he was dehydrated, and diagnosed with Diabetic Ketoacidosis. In addition, there was a nasty abscess found on his back from an old spider bite that happened a month ago. Kyle was given lots of IV fluids, which helped.
- Explain what is going on with Kyle now? How did he end up with DKA?
- Why the old spider bite did not heal and turned into an infection?
- Why was he given IV fluids? And how did that help?
- 3 years later, Kyle has his diabetes under control. He is traveling today from San Francisco to New York, but due to bad weather, his flight was delayed, as the passengers waited inside the plane for 2 hours before the take off. Now that the plane is finally in the air, Kyle started acting strange, nervous and anxious. The flight attendant noticed that Kyle was shaking and sweaty. She offered him some 7UP. When Kyle had the beverage, he felt better.
- Explain, what happened in this case: why did Kyle act strange and was shaking and sweating.
- Why drinking the 7UP helped?
Expert Solution Preview
In this scenario, we are presented with a case of a young adult named Kyle who has been diagnosed with Diabetes Mellitus type I at a young age. The scenario describes two different situations that have occurred in Kyle’s life with varying health implications. In the first case, Kyle has been diagnosed with Diabetic Ketoacidosis due to a spider bite that turned into an infection. In the second case, Kyle experiences anxiety and nervousness while on a flight, but drinking a 7UP helps alleviate his symptoms. Below are the answers to the questions asked in the scenario.
i) Kyle is currently suffering from Diabetic Ketoacidosis (DKA). DKA is a life-threatening complication of Diabetes Mellitus type I that results from the lack of insulin, causing the body to start breaking down fat instead of glucose. The by-products of fat breakdown, called ketones, start building up in the bloodstream, leading to ketoacidosis. As a result, the blood glucose level rises, and the body becomes dehydrated. Absence of insulin therapy, infections, and other stress factors can trigger DKA.
ii) Spider bites can cause inflammation in the affected area, leading to cell death, with potential for bacterial infection if not properly cleaned or if the immune system is compromised. In Kyle’s case, the spider bite turned into an abscess, indicating a bacterial infection. Bacterial infections can be challenging to treat in individuals with Diabetes Mellitus type I, as they tend to weaken the immune system and make it difficult for wounds to heal.
iii) Kyle was given lots of IV fluids to counteract the dehydration caused by DKA. Given that DKA is a metabolic state, it is essential to restore the fluid levels in the body. IV fluids can help by supplying the necessary electrolytes and glucose levels, which promotes recovery. Prompt administration of IV insulin can help to reverse DKA; however, its administration can be delayed to avoid worsening the dehydration caused by initial hyperosmolarity.
i) Kyle’s symptoms of shaking and sweating suggest that he may be experiencing hypoglycemia, a common complication in individuals with controlled Diabetes Mellitus. Hypoglycemia is a result of low glucose levels in the bloodstream, leading to hunger, confusion, sweating, and shaking. The delay in the flight caused Kyle to miss a meal, leading to low glucose level, which precipitated the symptoms.
ii) Drinking 7UP provided a boost in glucose levels, which restored a normal blood sugar level in Kyle’s bloodstream, thus alleviating his symptoms of hypoglycemia. Drinking 7UP or other sugary drinks can help during a hypoglycemic episode, as it can rapidly increase the bloodstream glucose levels. However, these should be used with caution since they do not provide a long term solution and can lead to hyperglycemia if consumed excessively. Regular meals and snacks spaced throughout long intervals can help prevent hypoglycemic episodes.