Question

A 72-year-old with hyperosmolar hyperglycemic state (glucose 800 mg/dL, effective osmolality 330 mOsm/kg), no acidosis. First priority in management?

Accepted Answer

Aggressive isotonic crystalloid resuscitation

Answer

Immediate insulin bolus then infusion

Answer

Rapid correction of sodium with hypertonic saline

Answer

Empiric bicarbonate

Answer

Start vasopressors early

Practice question

A 72-year-old with hyperosmolar hyperglycemic state (glucose 800 mg/dL, effective osmolality 330 mOsm/kg), no acidosis. First priority in management?