Ketoacidosis

A patient arrives at your internal medicine clinic. It is a young woman (23 yo) and she complains of abdominal pain, nausea, sore throat, and blurred vision since this morning. She attended a summer music festival and she admitted consuming a large amount of alcohol and use of methamphetamine IV.

She was diagnosed with type I diabetes at the age of 14. She self-administered her last dose of insulin yesterday evening, she missed her morning dose because she did not feel well, she did not eat, and vomited.

What is the most likely diagnosis of this patient?
23
years
woman
RR
30 /min
HR
106 /min
SpO2
100 %
BP
101/70 (80) mmHg
Examination
Dehydratation and tachypnoe is apparent.