A history should elicit what may have precipitated this diabetic crisis. The most common causes are infection, upper respiratory tract infection and gastroenteritis, or inadequate insulin therapy (Berger,aQd.,Kel|er,.1992). Check the patient's recent oral food and fluid intake, as well as his or her insulin and oral hypoglycemic drug use. Ask about other drugs, particularly illicit drugs and alcohol. Discuss the patient's normal diabetic control and diabetic complications such as nephropathy, neuropathy, and retinopathy. A history may be available from relatives or ambulance officers if the patient is unconscious.

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