An emergency department physician tells you that the hyperglycemic diabetic you brought in earlier has a pH of 7.40. What is the likeliest explanation of this statement?
A) The patient is a type II diabetic who was no longer secreting enough insulin to prevent the use of fats for energy.
B) The patient is a type II diabetic who was secreting enough insulin to prevent the use of fats for energy.
C) The patient is a type I diabetic who did not take his insulin and is therefore unable to use glucose for energy.
D) The patient is a type I diabetic who took his insulin and did not eat, resulting in the breakdown of proteins for energy.

Question

Quizplus · Accepted Answer

A pH of 7.40 is within the normal range and indicates that the patient's acid-base balance is not significantly disturbed. In diabetic patients, a pH that falls outside of the normal range (usually below 7.35) indicates that they are in diabetic ketoacidosis, which is caused by the breakdown of fats for energy, leading to an increase in ketones and a decrease in pH. However, with a pH of 7.40, the patient is likely not in diabetic ketoacidosis. In type II diabetes, the pancreas still produces insulin, but the body has become resistant to its effects. With proper management, type II diabetic patients can prevent the use of fats for energy and maintain normal acid-base balance, which seems to be the case with this patient.

An Emergency Department Physician Tells You That the Hyperglycemic Diabetic