An individual with diabetes mellitus who forgets to take insulin has the following data: pH = 7.29; [HCO₃⁻] = 12 mEq/L; Pco₂ = 26 mm Hg.Which acid-base disturbance is consistent with this clinical scenario and these arterial blood gas measurements?

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The data shows a low pH (7.29), indicating acidemia. The low bicarbonate ([HCO3-] = 12 mEq/L) suggests a primary metabolic acidosis. The decreased Pco2 (26 mm Hg) is consistent with respiratory compensation for the metabolic acidosis. This pattern is typical in diabetic ketoacidosis, where insulin deficiency leads to increased ketone production and acidosis, with compensatory hyperventilation to blow off CO2.

An Individual with Diabetes Mellitus Who Forgets to Take Insulin