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ModerateEndocrinologyHyperosmolar hyperglycaemic stateuk-plab-1

A 78-year-old man with long-standing type 2 diabetes presents with confusion, profound thirst and polyuria. Capillary glucose is 38 mmol/L. Serum osmolality is 330 mOsm/kg, ketones are 0.4 mmol/L and pH is 7.38. What is the most likely diagnosis?

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