A patient with diabetes who misuses drugs and alcohol may be at risk for ketoacidosis.
Patient selection: diabetic
Substance abuse may:
(1) impair the patient's ability to control the diabetes
(2) mask early signs of impending ketoacidosis
(3) lead to multiple readmissions in ketoacidosis
Diabetes ketoacidosis in turn may mask substance abuse and make management of an overdose more difficult.
The substance misuse may go undetected unless the patient is screened with both direct questions and urine drug testing.
