A 66-year-old man with type 2 diabetes mellitus and chronic alcohol consumption presented to an acute care hospital with generalized fatigue, anorexia, and melena. On arrival, he was in hypovolemic shock and required immediate resuscitation. He exhibited severe metabolic acidosis due to concurrent lactic acidosis and diabetic ketoacidosis (DKA). Additionally, he developed acute kidney injury, necessitating emergency hemodialysis, and was subsequently transferred to our hospital for further management.
