A 78-year-old man with type 2 diabetes is admitted with severe hyperglycaemia (glucose 35 mmol/L), osmolality 330 mOsm/kg, minimal ketonaemia and prof...

Question

A 78-year-old man with type 2 diabetes is admitted with severe hyperglycaemia (glucose 35 mmol/L), osmolality 330 mOsm/kg, minimal ketonaemia and profound dehydration. He is drowsy but has no Kussmaul respiration. What is the most likely diagnosis?

Accepted Answer

Hyperosmolar hyperglycaemic state

Answer

Diabetic ketoacidosis

Answer

Hypoglycaemia

Answer

Lactic acidosis from Metformin

Answer

Acute adrenal crisis

uk-plab-1 MCQ (SBA): Hyperosmolar hyperglycaemic state

A 78-year-old man with type 2 diabetes is admitted with severe hyperglycaemia (glucose 35 mmol/L), osmolality 330 mOsm/kg, minimal ketonaemia and profound dehydration. He is drowsy but has no Kussmaul respiration. What is the most likely diagnosis?