Hi. It looks like it's Endocrinology time.
Case 1. He has diabetic ketoacidosis. He is a young recognized diabetic person, with a high probability of type 1 diabetes because of his age. We must perform gasometry to corroborate the diagnosis.
He has to receive treatment in an intensive therapy unit. We have to supply hydration with saline solution 0.9% at first gradually for 24 hours. Insulin regular in infusion pump at rate 0.1 units per kg per hour. Remember always potassium infusion.
The adjust will do depend on the evolution during a strict supervision.
Besides we have to look for a trigger factor.
Case 2. It could be a Graves disease. We must perform thyroid hormones, thyroid stimulating antibodies, and thyroid ultrasound. Treatment is based on antithyroid drugs and beta-blockers. It is important an ophthalmologic evaluation for following orbitopathy.