DKA. Not the diabetic who's had a nasty GI bug, infection or surgery, or something that could reasonably make their sugars go wild, the ones we get every 2 or 3 weeks, usually young, and the biggest pains in tail you can imagine. They don't do fsbs or take their insulin, despite being taught multiple times, being sent home with FREE supplies for fsbs and free insulin pens, always come in with uncontrolled n/v/d (and the CT shows a full GI tract, it's called, "keep that dilaudid coming!"). Always have a positive drug screen, and not a single mark on their fingers that they've checked their sugars since their last admission -- but they're on disability because of their diabetes (makes you wonder if that's why they don't treat it). And I always look over at the person who's post-dialysis hypotension, or post BKA, or evolving stroke, or fresh MI, all from untreated diabetes, and I just want to drag them into the other patient's room and say, "This is your future. Right here. These smells. These missing limbs, these necrotic feet, that dialysis machine, that sign saying 'Patient is Blind,' that person who's trached, PEG'd and on their way to a nursing home for the rest of their life, just because they didn't treat their diabetes. Now do what you're supposed to do, not what you WANT to do."
