2.3  Physic examination
His temperature was 36.5°C, heart rate was 117 beats per minute with weak peripheral pulses, blood pressure was 135/95 mm Hg. He was 179 cm tall and weighed 105 kg, with BMI 32.77 kg/m2. Physical findings were remarkable for abdominal obesity with waist circumference of 99 cm. Mild acanthosis nigricans was present on his neck and axillae. His respiratory rate was 24 breaths per minute with a Kussmaul pattern and smelled of acetone. His fingers and toes were cool, with a prolonged capillary-refill time. Examination of the lungs and heart revealed no abnormalities and the abdomen was soft, with mild, diffuse tenderness but no guarding or rebound. There was no clinical evidence of diabetic retinopathy, neuropathy or nephropathy.