A 45-year-old man with type 2 diabetes, hypertension, and chronic renal failure was admitted to the hospital with a 3-day history of upper abdominal pain, anorexia, nausea, low-grade fever, and altered sensorium. He had had diabetes for 8 years, and hypertension and renal failure for 9 months but had not undergone dialysis. The patient was receiving therapy with glipizide, 20 mg qd, and phenformin, 100 mg qd, for his diabetes, and amlodipine, 10 mg qd, clonidine, 0.2 mg qd, metoprolol, 100 mg qd, minoxidil, 2.5 mg qd, and furosemide, 40 mg qd, for his hypertension. He stopped receiving his oral hypoglycemic agents 3 days before hospital admission because of reduced food intake but was still taking his antihypertensive medications. He procured all his medications from India.