(Disclaimer: This article is for scientific purposes only. In order to protect the patient’s privacy, the relevant information in the following content has been processed) Abstract: A 65-year-old elderly diabetic woman suffering from acute gastroenteritis presented with symptoms of thirst, dyspnea, and drowsiness. Blood gas examination suggested metabolic acidosis, blood lactate was significantly elevated, blood glucose was mildly elevated, and urine routine ketone body was positive. In this case, it was considered that the patient suffered from lactic acidosis, and she was immediately given rehydration, acid correction, insulin supplementation, and anti-infective treatments, etc. The patient responded favorably to the treatment, and was discharged from the hospital after 5 days. Basic information] Female, 65 years old [Type of disease] Lactic acidosis, acute gastroenteritis, diabetes mellitus [Hospital] The Second Affiliated Hospital of Harbin Medical University [Date of consultation] September 2011 [Treatment plan] Medication (sodium chloride injection + sodium bicarbonate injection + dextrose injection + glucose injection + glucagon injection + ceftazidime for injection + potassium chloride injection) Hospitalization for 5 days 【Treatment effect】 The condition was controlled and all indicators improved I. Initial interview 65-year-old female patient with a history of diabetes mellitus and good blood glucose control after treatment with insulin. She was brought to the hospital by her family because of nausea and vomiting for 2 days and dyspnea for 4 hours. Nausea, vomiting, gastrointestinal cramps and diarrhea occurred after eating take-out food for 2 days prior to the onset of the disease, with diarrhea consisting of dilute watery stools more than 10 times a day. She was treated with oral montelukast and other medications, and the symptoms of abdominal pain and diarrhea improved slightly, but she still had nausea and vomiting, and gradually developed symptoms of thirst, dyspnea, and weakness. Four hours before arrival at the hospital, family members found that the patient’s dyspnea worsened and mild drowsiness appeared. Immediately after the consultation, the patient’s blood pressure was measured and found to be 90/60 mmHg, usually around 110/80 mmHg, with a heart rate of 102 beats/min. Considering that the patient was in hypovolemic state, blood gas examination was completed at the same time, and the results were as follows: pH: 7.05, partial pressure of carbon dioxide: 12mmHg, partial pressure of oxygen: 119mmHg, HCO3: 3.3mmol/L, lactic acid concentration: >15mmol/L, and blood glucose: 9.7mmol/L. Urgent urine analysis was performed: negative for urinary glucose, urinary ketone bodies (++), and urinary proteins (+). ). Lung CT: no abnormality. Preliminary diagnosis: metabolic acidosis, lactic acidosis, acute gastroenteritis. Treatment Considering the patient’s age, high blood lactate level and serious condition, he immediately explained to his family that his condition was critical and was admitted to the hospital for emergency treatment. Further complete liver and kidney function, electrolytes, intravenous blood glucose, blood routine and other laboratory tests and abdominal liver, gallbladder, spleen, both kidneys, urinary tract, intestines and pelvic ultrasound, to exclude the possibility of acute abdomen. The results were returned as follows: blood leukocytes 18×10^9/L, blood biochemistry: creatinine 126 μmol/L, urea 9.6 mmol/L, blood glucose 10 mmol/L, blood potassium 5.0 mmol/L, and abdominal and pelvic ultrasound did not show any significant abnormality. Rapidly apply sodium chloride injection and other drugs to dilate, replenish blood volume, and improve tissue perfusion; apply sodium bicarbonate injection to correct acidosis, and at the same time, monitor the blood gas every 1-2 hours, and according to the results, adjust the dose of sodium bicarbonate injection; apply dextrose injection with glucagon injection to control blood glucose, reduce anaerobic glycolysis, and decrease lactic acid production; apply ceftazidime injection to anti-infective treatment, and at the same time, monitor the blood potassium level, and apply cephradine injection to prevent infection. At the same time, blood potassium level was monitored, and potassium chloride injection was supplemented according to the result, and hypokalemia was prevented after insulin use. Third, treatment effect After these treatment measures were given, the patient’s blood pressure was the first to recover, and at about 3 hours of rapid rehydration, the blood pressure gradually recovered and stabilized to the usual normal level, and the hourly urine output was above 40 ml. In addition, the patient’s blood lactate level gradually decreased and blood glucose was relatively stable. After 12 hours, the patient’s consciousness completely returned to normal, nausea and vomiting were basically relieved, dyspnea was significantly reduced, and he could eat and drink fluids. After 5 days of hospitalization, the patient’s gastrointestinal discomfort had basically disappeared and there was no dyspnea. Review blood gas examination, the results are as follows, pH: 7.42, partial pressure of carbon dioxide: 36 mmHg, partial pressure of oxygen: 94 mmHg, HCO3: 23.4 mmol/L, lactate concentration: 1.0 mmol/L, blood glucose: 7.2 mmol/L, blood leukocytes decreased to 8.0×10^9/L, liver and kidney function is normal, blood sodium, blood potassium is normal, and it is recommended that the patient be discharged from the hospital. IV. Precautions We are glad that the patient’s uncomfortable symptoms disappeared and the indexes improved after hospitalization. It is recommended that the patient should pay attention to rest after discharge, and once suffering from infectious diseases should be detected and treated as early as possible. Daily can moderate more water and dietary fiber-rich foods, such as winter melon, cauliflower, avoid drinking alcohol. For diabetic patients, but also control diet, moderate exercise, regular use of hypoglycemic drugs to control blood glucose, regular monitoring of blood glucose, do not arbitrarily stop or reduce the amount of drugs. V. Personal perception Diabetic patients in the complication of colds, diarrhea, alcoholism, is very easy to acidosis problems, such as this case patients, the clinical manifestations of frequent nausea, vomiting, dry mouth, thirst, deep and large breathing, dry skin and lips, peripheral weakness, lethargy, and so on, and serious coma will occur. Once the family found that the patient has two or more of the above symptoms, they need to go to the hospital urgently, improve the blood gas examination, 2 minutes can initially determine whether the patient has lactic acidosis, whether there is severe hyperglycemia caused by high osmolality, combined with the urinalysis, it can be initially determined whether there is ketoacidosis or not, which can buy time for timely treatment.