Differential Diagnosis

Uncontrolled diabetes

Renal failure from a variety of causes

Tissue hypoxia

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GI h2co3 loss from diarrhea

Methanol intoxication

Suggested Additional Lab Testing

Urinary ketones might be valuable to show increased ketoacids in uncontrolled diabetes.

Urinary changes that show impaired hydrogen excretion suggest renal failure.

Increased lactic acid in the blood is suggestive of tissue hypoxia.

Formic acid may be helpful in identifying methanol intoxication.