Consider the following medical report that includes the patient's historical health records. Use it to predict the disease that the patient is high likely exposed to. 

 Medical Report: history of present illness: mr. is a 53-year-old male with a history of insulin dependent-diabetes mellitus, multiple past episodes of diabetic ketoacidosis, peripheral neuropathy, and alcohol abuse, who presented with nausea and vomiting and decreased oral intake approximately five days prior to admission which led him to stop taking his insulin approximately four days prior to admission. he also complained of polydipsia and polyuria after discontinuing his insulin. on admission, he also noted subjective fevers, no chills. he also complained of lower chest pain burning and mouth acid burning consistent with prior reflux symptoms. he had no exertional chest pain, no shortness of breath, no abdominal pain. on admission, he has a significant anion gap approximately 70, a bicarb of 5, serum glucose of 1,114, and urinalysis positive for greater than 80 ketones, greater than 1,000 glucose. past medical history: 1. diabetes for 10 years, insulin dependent. 2. peripheral neuropathy mainly effecting feet bilaterally. 3. left foot ulcers. 4. gastroesophageal reflux disease status post hernia repair. 5. alcohol abuse. 6. coronary artery disease. transthoracic echocardiogram in with global hypokinesis and an ejection fraction estimated at 20-30%. allergies: no known drug allergies. medications: 1. insulin nph 25 units in the am, 15 units in the pm. 2. regular insulin 12 units am, 8 units pm. 3. mavik 1 mg. 4. sucralfate. 5. viagra prn. family history: mother with diabetes mellitus. social history: lives alone at the , positive tobacco history, positive alcohol abuse history, positive occasional marijuana use. review of systems: denies hematemesis, melena, bright red blood per rectum, and has regular bowel movements. physical examination: vital signs: afebrile, heart rate 100, blood pressure 120/55, respiratory rate 20, and oxygen saturation 98% on 2 liters. general: well-developed disheveled white male in no acute distress. heent: normocephalic, atraumatic. pupils are equal, round, and reactive to light. extraocular movements are intact. anicteric. neck: no lymphadenopathy, supple. chest: clear to auscultation bilaterally. cardiovascular: tachycardic with regular, rate, and rhythm, normal s1, s2, no murmur, gallop, or rub. negative jugular venous distention. abdomen: flat, soft, nontender, nondistended, no masses. extremities: no clubbing, cyanosis, or edema. left foot has an ulcer on the plantar midfoot region with crusted blood, no erythema, no sign of infection. neurologic: alert and oriented, moving all extremities, fluent speech, decreased sensation in feet bilaterally. skin: no erythema, no rashes. numerous nevi on trunk and back. laboratories: white blood cell count 17.6, hematocrit 44, platelets of 282. sodium of 120, corrected sodium of approximately 134, potassium 5.1, chloride 67, bicarb of 5, bun 63, creatinine at 2.4, glucose 1,114. urinalysis: specific gravity 1.020, greater than 1,000 glucose, greater than 80 ketones, 0-2 white blood cells per high power field, no bacteria, no epithelial cells. urine tox screen negative. electrocardiogram: sinus tachycardia, no significant change from prior electrocardiograms. chest x-ray: negative. hospital course: 1. endocrine: patient presented in diabetic ketoacidosis with an anion gap of 70 due to patient not taking insulin in the setting of nausea, vomiting, and decreased po intake. the patient was admitted to the micu, and was treated with an insulin drip and aggressive intravenous fluid repletion. he was switched to his home nph and regular insulin dosing once the anion gap closed on hospital day #2. his potassium and phosphate were aggressively repleted, and he received insulin teaching from the learning center demonstrating good insulin administration technique, and good use of glucometer. he was scheduled for a follow-up appointment with his primary care physician, . on at 2:30 pm. 2. cardiac: the patient ruled in for a non-q-wave myocardial infarction with a peak ck of 310 on , peak troponin of 21.8 on . a non-q-wave myocardial infarction was likely secondary to diabetic ketoacidosis and not a precipitating factor for diabetic ketoacidosis since cardiac enzymes peaked on hospital days two and three. an echocardiogram obtained on showed an ejection fraction of 20-25%, significant spontaneous echocardiogram in left ventricle without thrombus. impression: unchanged from prior echocardiogram from . cardiology was consulted, and felt that patient likely does not have active ischemia. the cardiomyopathy was a result of diabetic microvascular disease. the patient also has a history of alcohol abuse and thus may have a component of alcoholic cardiac myopathy. however, given the high peak troponin, there was a small concern for coronary artery disease. the patient was placed on a heparin drip for approximately 48 hours, and underwent cardiac catheterization on , which showed no coronary artery disease and normal filling pressures. the patient was placed on aspirin, lopressor, and captopril, which were titrated up as tolerated. the patient's lipid profile was triglycerides 92, hdl 52, ldl 77, thus lipitor was discontinued. 3. gastrointestinal: patient had elevated amylase and lipase with a lipase of 160 and an amylase of 166. this was thought to be secondary to diabetic ketoacidosis versus mild pancreatitis. he was asymptomatic. he was placed on clears initially and his diet was advanced as tolerated. because of his history of gastroesophageal reflux, he is also placed on protonix. 4. foot ulcer: history of charcot foot, the patient has a left plantar ulcer and no sign of infection. there is no evidence of osteomyelitis on films. podiatry was consulted, and he had a gauze wet-to-dry bandage changed . plan to followup with podiatry next week with dr. . appointment was made for wednesday, at 9:45 am in the far complex. 5. skin: patient has numerous nevi on trunk and back. a full skin examination by dermatology may be appropriate on an outpatient basis in the future. 6. depression: the patient reports decreased mood especially with seasons and decreased motivation. it is possible that his decreased mood may be contributing to his noncompliance with his medication regimen. at this point, it was felt beginning an antidepressant may be appropriate on an outpatient basis once it has been demonstrated that he can stick to his current medication regimen. discharge condition: stable. discharge status: discharged to home. diagnoses: 1. diabetic ketoacidosis. 2. non-q-wave myocardial infarction. discharge medications: 1. pantoprazole 40 mg q day. 2. aspirin 325 mg q day. 3. folic acid 1 mg q day. 4. thiamine 100 mg q day. 5. sodium phosphate two packets po qid. 6. regular insulin 12 units in the am, 8 units in the pm. 7. nph insulin 28 units in am, 20 units in pm. 8. atenolol 25 mg q day. 9. lisinopril 10 mg q day. 10. multivitamins one tablet q day. follow-up appointments: 1. pcp, . on at 2:30 pm building, phone #. 2. cardiology, dr. , at 11:30 am, building, phone #. 3. podiatry, dr. , at 9:45 am far complex, phone #. dr., 12-735 dictated by: medquist36 procedure: combined right and left heart cardiac catheterization coronary arteriography using two catheters diagnoses: other primary cardiomyopathies subendocardial infarction, initial episode of care esophageal reflux polyneuropathy in diabetes depressive disorder, not elsewhere classified alcohol abuse, unspecified diabetes with ketoacidosis, type i [juvenile type], not stated as uncontrolled ulcer of heel and midfoot diabetes with neurological manifestations, type i [juvenile type], not stated as uncontrolled 

Answer: The patient is high likely exposed to