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Linda M. Roberts
Department of Chemistry
California State University, Sacramento
Diabetes and Acid/Base Chemistry: A Case of Diabetic Ketoacidosis (DKA)

This case study focuses on a teenage patient with type 1 diabetes mellitus (T1DM) who presents with severe acidosis, becomes combative and loses consciousness, and is subsequently treated and released. The scenario is used to teach the topics of metabolic hormones, cellular respiration, fat and carbohydrate metabolism, clinical analysis, and treatment. The case incorporates chemistry concepts related to ketone bodies, acid/base chemistry, blood buffer equilibrium, and Le Chatelier's principle in a setting that is pertinent to nursing and health care students. The level of difficulty is appropriate for beginning chemistry students and could be used in secondary or college classrooms. The case includes ample clinical measurements and vitals for performing calculations, which can also be used for graphing exercises. Higher-order topics that could be explored upon completion of the case to assess student understanding include vomiting during acidosis, acidosis related to exercise (lactic acidosis), respiratory acidosis (COPD and pneumonia), and acidosis related to alcoholism.