A 70 year old male with altered sensorium,shortness of breath .
A 70 year old male ,resident of ramannapet,industrial worker by occupation came to casuality with, C/O Altered sensorium since morning 5am and Shortness of breath since morning 5am. History of presenting illness: Patient was apparently asymptomatic 20 years back and then he went to regular check up and got diagnosed with Diabetes Mellitus ,he was prescribed oral antihyperglycemic drugs which is continuing till now. 18 years back ,he had a H/O trauma to his little toe of left leg and he developed cellulitis to his little toe .So he went to a hospital and got his left little toe amputated and was covered with skin grafting at that place . 6 years back ,he had a H/O cellulitis to his left lower leg .So he went to a hospital and got fasciotomy in that area ,since then insulin has been started,Mixed insulin (30/70) 35U * 30U 7 months back ,he went for regular check up of diabetes , then he diagnosed with a kidney problem and he was prescribed with a medication of