A 75-year-old woman with long-standing hypertension and diabetes presents with confusion and marked hyperglycaemia. Capillary glucose is 42 mmol/L, se...

Question

A 75-year-old woman with long-standing hypertension and diabetes presents with confusion and marked hyperglycaemia. Capillary glucose is 42 mmol/L, serum osmolality is 328 mOsm/kg, pH is 7.36, and ketones are minimal. What is the cornerstone of initial management for this condition?

Accepted Answer

Large-volume isotonic crystalloid resuscitation

Answer

Immediate high-dose intravenous insulin bolus

Answer

Intravenous sodium bicarbonate

Answer

Urgent haemodialysis

Answer

Oral hypoglycaemic agents

ca-mccqe1 MCQ (SBA): Hyperosmolar hyperglycaemic state

A 75-year-old woman with long-standing hypertension and diabetes presents with confusion and marked hyperglycaemia. Capillary glucose is 42 mmol/L, serum osmolality is 328 mOsm/kg, pH is 7.36, and ketones are minimal. What is the cornerstone of initial management for this condition?