87 year old man with history of COPD and type 2 DM on insulin and metformin, was found unconscious. His VBG showed the following.

PH = 7.23

pCO2 = 62 mmHg

HCO3 = 25 mmol/L

Hb = 138 g/L

Na = 141 mmol/L

K = 4.6 mmol/L

Cl = 109 mmol/L

Glucose = 2.0 mmol/L

Lactate = 1.6 mmol/L

Creatinine = 161 umol/L

Questions:

1. Interpret these blood gases results
2. How will you manage this patient?