- Alexandra Dent, foundation year 1 doctor1,
- David Walmsley, consultant diabetologist and endocrinologist1,
- Shankar Dhandapani, specialist registrar in diabetes and endocrinology1
- 1Royal Lancaster Infirmary, Lancaster LA1 4RP, UK
- a.dent{at}doctors.net.uk
We recently admitted a man in his 80s with poor glycaemic control and osmotic symptoms. His medical history included chronic kidney disease, macrocytic anaemia, hypothyroidism, hypertension, osteoarthritis, and splenectomy. Glycaemic control was managed by twice daily insulin. On admission, creatinine concentration was 147 µmol/L, urea 8.5 mmol/L, and potassium 5.1 mmol/L while taking lisinopril. He was taking no other drugs …
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