A 30 year old man is brought to your ED by ambulance. He was found lying on his garage floor unconscious by his girlfriend after an earlier argument. He is a NIDDM on Metformin and has some psychological problems on Quetiapine.

The patient is a car enthusiast and works as a mechanic.

On Examination:

BP 110/70  HR 130 Sats 96RA  RR 24  T  36.4

GCS 13  (E3,M6,V4)

Pupils 3mm, equal

Moving limbs, no sign of trauma

pH         7.05

HCO3      10    mmol/l          

PCO2      25    mmHG

Na         144  mmol/l

K             4.0 mmol/l

Cl            105  mmol/l

Urea        8      mmol/l

Creat       120  umol/l

Ca            0.99 mmol/l

Lactate    18   mmol/l

Glucose    6     mmol/l

Describe and interpret the blood tests

How would you treat him?