VISUAL VIGNETTE

On examination, he was febrile (temperature, 38.0°C), had tachycardia (pulse, 123 beats/minute), and normal blood pressure (133/72 mm Hg) and oxygen saturation (99% at breathing room air). Laboratory investigation showed a serum glucose of 727 mg/dL, bicarbonate of 25 mmol/L, lactate of 1.5 mmol/L, creatinine of 1.61 mg/dL, blood urea nitrogen of 59 mg/dL, leukocytes at 26,710/μL, and glycated hemoglobin at 10.2% (88 mmol/mol). Address correspondence to Dr. Kyung Ae Lee, Division of Endocrinology and Metabolism, Department of Internal Medicine, Research Institute of Clinical Medicine of Chonbuk National University-Biomedical Research Institute of Chonbuk National University Hospital, Chonbuk National University, Medical School, 20 Geonji-ro, Deokjin-gu, Jeonju 54907, Korea.