Diabetes is a disease in which the body does not produce or use insulin properly. Insulin is a hormone that is needed to convert sugar, starches and other foods into energy that is needed for fuel in daily activities (American Diabetes Association [ADA], 2006, p. 1). There are two types of diabetes, Type 1 and Type 2. Type 1 is caused by the body's failure to produce insulin, and has an abrupt onset in childhood or adolescence, that usually requires insulin injections to prevent ketosis (Ignatavicius, Workman, & Mishler, 1995, p. 1858). Type 2 is caused by insulin resistance (ADA, p. 2), and has a slow onset in the middle-aged, and may require "insulin or sulfonylurea therapy to correct hyperglycemia" (Ignatavicius et al., p. 1858).
Joey is a 15 year-old Caucasian male, lean framed and middle class with new onset Diabetes Type 1, who was having symptoms of frequent urination, excessive thirst, extreme hunger, increased sweating, and felt as though his heart was beating out of his chest.
These symptoms were occurring for over three days before he informed his parents. His parents are very busy attorneys with a large firm, so they spend a great deal of time away from home. Joey is an only child and is mostly self sufficient, and does not like to bother his parents unless necessary. This is why he waited so long to tell his parents how he was feeling. His parents took him to see his family doctor, and he discovered that Joey had ketones in his urine, and a blood sugar level of 350mg/dl. Of course this alerted the MD of an impending Diabetic Ketoacidosis (DKA), so he ran an arterial blood gas and electrolyte panel. His blood gas showed a pH of 7.33, and a HCO3 of...